lap band v. rny:still mulling it over-but have more questions

I'm still trying to decide between RNY and Lap Band. I started out feeling sure about the RNY then got freaked out by the whole food intollerance/dumping thing. So I started to really research Lap Band and became even less sure about any decision. Lap Band has it's own pitfalls too. It's touted as less invasive, but stories of band slippage, errosion, ulcers, necroted stomach tissue, port flipping, leaking, infection, etc. have really got me running for cover. All of that makes food intollerances seem minor in comparison. However, some points still need clarifying please: 1. what is PB or PBing? 2. what is "The Window of Opportunity" 3. what is behind this discussion of RNYers not learning good eating habits and regaining the weight? There seems to be a sentiment on the LB message board that weight flies off for RNYers then they hit a huge plateau and start to regain because they can eat more volume than GBers? Or something like that......... 4. what is a typical daily diet of someone say 6 months out? 5. Is spicy food tollerable post surgery? I am likely to stick with the RNY decision I intially made, however any input you have at this point is really appreciated. I am really begining to see what a life changing event this surgery represents. Thanks for your feed back! Jean B.

oops, forgive me I just posted this to the wrong board, but actually, you grads would be great to get feed back from!!! thanks! Jean

Jean, I chose the rny because it is PERMANENT, and the use of it as a tool can be permanent as well. Also, I didn't want to have to go for these "fills" and crap. I wanted to be DONE. As with any tool, it can be used or abused. A person who doesn't work on their food issues, regardless of what they do to get the weight off, are going to gain if they go back to the old bad food habits that got them fat in the first place. I am two and a half years out. That means that my stomach is now roughly the size of a small grapefruit. It will hold approximately eight ounces of food. Now - if I put 8 ounces of chocolate at about a thousand calories, instead of a little chicken, a little vegetables, etc. at about 350 calories, what do you think is going to happen? I don't mean to say that I *never* indulge in wrong foods, but I am very calorie conscious and I pay attention to my body. You CAN gain it all back - but if you pay attention, develop good eating and calorie burning habits , you can and will be successful. I believe that PBing refers to plateau busting. The "window of opportunity" is the six months or so that the average RNY patient experiences no hunger pangs. Everyone plateaus - EVERYONE. It is the body's natural response. It stops to catch up. I can eat pretty much anything I like, within reason. I love spicy food and have no problem with it. Each of us is quite unique. What makes one person dump might not make another dump. It's a "learn as you go" thing. Good luck and God bless ~ I almost hate to say this, but I had zero negative side effects with my open RNY. I was back at work within two weeks and would have gone back sooner if my daughter hadn't thrown such a fit. Write any time!

Jean, WLS is a tough decision...once you go that route there is no turning back so you should know what you are getting into and understand it fully. I originally wanted lap band but with the weight I had to lose I didn't think it would make me happy. I also was not keen on the problems that came with banding. I too thought dumping sounds minor compared to them. I have been forunate and really don't dump. I don't push the sugar/fats grams restriction either which may have helped me not to dump. The stories just scared me to death. And I will tell you I have heard some scary ones! I didn't see you mention Duedonal Switch (DS) which is another method of WLS you may want to consider. I just couldn't find surgeon in my area that did it and my insurance would not cover it. So when choosing you may want to check out what the insurance will cover otherwise you may be looking at a large bill. 1. what is PB or PBing? PB = Plateau Buster diet. Its pretty much how we eat in the beginning of our journey. HOW TO BREAK A PLATEAU #1 - Do this for 10 days to break a plateau #2 - Drink 2 quarts of water a day #3 - You must have 45 grams of protein supplement and all your vitamins/minerals supplements each day #4 - You may consume up to 3 oz of the following high protein foods, 5x a day beef pork chicken turkey lamb fish eggs low fat cheese cottage cheese plain yogurt or artificially sweetened (?) peanut butter beans/legumes You may also have: sugar free popsicles tea or coffee sugar free soda sugar free jello broths/bullion (sp?) crystal light drinks #5 - If it's not on the list, you can't have it for 10 days!!!! #6 - Keep a food diary and try to get up to 30 mins of exercise daily 2. what is "The Window of Opportunity" Window of Opportunity is what timeframe the surgery will allow us to maximize a weight loss.....My Dr. says 12-18 mos. But I have seen people stop losing at 9 mos. Or lose very little like me at 22 months. 3. what is behind this discussion of RNYers not learning good eating habits and regaining the weight? This is a true statement here....if you don't learn to eat right and go back to old habits you will gain. You won't gain it all back according to my Dr but you will gain 50% of your loss if you are not careful. Its a lifetime committment to eating and exercising right! If you aren't in it for a lifetime forget it! There seems to be a sentiment on the LB message board that weight flies off for RNYers then they hit a huge plateau and start to regain because they can eat more volume than GBers? Or something like that......... I don't think the weight flies off...I didn't seem that way for me. I had to work for those pounds. I exercised as soon as I came home. I still do. Not as good as I did early on but I continue to get myself back into that realm. I won't give up. I plateaued alot....3 mos, 6mos, 99 lbs, 12 mos......Now! Your stomach stretches with time....Yes I can eat a whole lot more now. I don't like it but its normal eating. About 1 cup a feeding. I do limit my feedings to 5x a day. I could cut back and probably should to get a few more pounds off. I would think the banders would have the same issues...if they eat too much they could damage the bad or worse their stomach. 4. what is a typical daily diet of someone say 6 months out? I have to find my old diary and I can supply you with a day that I ate then.... 5. Is spicy food tollerable post surgery? YES....About 3 months

I wanted the rny because I see dumping as an advantage, not a disadvantage. It is behavior modification. If you eat sugar/fat and you dump, you theoretically should learn to not do it again knowing the consequences. I dump on high sugar and/or high fats. but it is erratic. so I try real hard to be good the vast majority of the rime. A couple dumping episodes and I learn, albeit slowly at times. any one with any surgery can go into it thinking they can still eat whatever they want, or they can choose to learn new healthy habits. I have worked real hard to make my diet be focused on health. I slip sometimes, but overall I do well, because It is important to me to be healthy. If an rny doesn't change how they eat and exercise they will regain. If a lapbander doesn't change what they eat and exercise they will regain. I felt the rny gave me an advantage with the malabsorption of fats ( and 3 1/2 years out I still definately malabsorb fats) as well as the limitations on portions and the behavior modification of dumping. I can definately eat more now than immediately preop, but that is normal and expected. I couldnt have lived forever on an oz of food each meal. the typical diet of a person 6 months out is going to vary according to their commitment to their health and attaining a healthy weight. at 6 months I was working hard to consume 6 oz of meat , fish, or chicken in a day - divided into at least 3 meals. I was eating an egg for breakfast. I ate a few bites of veggies with each meal. My snacks were yogurt, cottage cheese type things. a piece of fruit or unsugared applesauce. I have always been on 6 meals a day. At 3 1/2 years out I eat more, but I am maintaining and doing well/ since about 2 years I have had 6oz meat, fish, or chicken, 3 servings of dairy a day, at least a couple servings of veggies or more, and 2 pieces of fruit a day and one of those is always a banana, I eat 2-3 servings of whole grains - ie oatmeal aprox 1 cup cooked, , smallest size whole wheat tortilla, ! slice whole wheat bread counts as 2, Kasji cereal. this ends up being aproximately 1500-1700 cals a day. about 150 grams carbs, 100+ grams protein , and aprox 50 grams of fat. If I feel the need to have extra after my 6 meals, I snack on pea pods, cherry tomatoes, cut up fruit, cheese, and/ or an occasional protein bar ( One way or detour only in the smallest size that has 15 grams of protein) I strive for an over all balance and a ratio of calories source as 40% carbs, 30% protein, and 30% fats. Now, I feel one of the very most important reasons I am maintaining so well to this point ( with in 5 pounds for over 2 years with the exception of dropping too low with an illeus and water gain with plastics) is EXERCISE! I exercise regularly. It is important to do something every day that gets your heart puming and the sweat flowing. to live an active lifestyle as the weight comes down and you are freer to do so. Park at the far end of the parking lot, bike ride, dance, play, go for walks, join a health club and attend - what ever strikes your fancy that you will like to do. and mix it op and just have fun with it. Since you are changing your life really go for it. make it a healthy new lifestyle. If you have kids include them in it , get them out walking, running and playing with you. teach them the good eating habits, focusing on them being healthy, not on their weight. don't bring junk food into the house. I have done this w/ my grandkids I take care of every day. My 7 y/o gransdson was told by his doctor after his tonsillectomy that he could eat pocicles and ice cream at every meal and he looked at the dr and said, "but I want to be healthy" My grand daughter (age 4) ask " can I have friuts and begtables (as she calls them) for lunch? this is telling me I am doing a good job. Good luck in your decisions and in starting a healthy new lifestyle!!!

There are different types of surgeries. Not all are for everyone. I left the decision to my surgeon as I felt he was the best one to know what was best for me. Lap band has improved greatly these past couple years. New materials are being used and therefore less slippage. There are some doctors in California that do the RNY and add the salastic ring for added measure. RNY, Proximal or Distal. Distal requires more maintenance than proximal. Then we have the Deuodanal Switch (DS). A completely different type also. So many choices. That's why I left the decision to my surgeon.... Good luck on your decision. Darlene

Hi Jean, Everyone has given you great advice already so the only thing I will add is that I had RNY and I have a younger sister who had the Lap based on what our Dr. Dx. Each of us are very satisfied with our perspectives surgeries. We have some similarities and some differences so we concluded that to each their own because the surgery is a tool and it is up to us to use it to our advantage. Whatever decision you make, I wish you all the best. Kenya

Just an FYI, PBing is Productive burping, check out the board.

Hi Jean!!! Get the book "Weight-Loss Surgery for Dummies" by Dr. M. Kurian. Good Luck with whatever you choose. Best, Leila