Pre-op question to WLS Grads, Your insight would truly help me.

Hi, My husband had lap-band surgery about four months ago and has lost 30 to 40 pounds. I was scheduled for a lap-band and changed my mind to the RNY. I am scheduled for RNY in fifteen days. I decided that the band was too slow for me and not restricted enough. I am under 250 pounds and have no other health problems yet. I have been reading some of your posts and they are making me lean more toward the band again. The bone density discussion worries me because my mom, not overweight, has had at least seventeen surgeries on different bones and I already have slight arthritis. I am also concerned about the thread about the bulging tummy, maybe due to eating carbs. What I am mostly afraid of is the thread about gaining weight so easily. With the band, you can keep having it adjusted (I think) so you don't have to get hungry even after a few years. I am not naive and know that the band will also take very hard work and commitment. I just don't know what to do and thought maybe you could tell me (from your experience) what you would do if you were me. I hope I haven't insulted anyone by posting on your board. Thanks so much and congratulations on your success, Risa

Risa, I cannot tell you which surgery would be the best for you they both have their draw backs. They are not the magic pill to get us to thinville forever but they are a quick start. With that said, RNY I think helps people that are heavier and have a lot to lose to lose it in the 18 mos window of opportunity. Looking at your weight I would have opted for the band. I wish I didn't wait till I was 425 to find help. The band may be slow but you have to work at losing the weight when you are further out in the RNY so to me they equal out in the long term. Bulging tummies do not happen to everyone....same with bone loss. Any surgery you choose requires a huge committment on your part to change you mindset with food. They operate on our stomachs not our head. That is our part! Good luck with whatever you decide. Debbie

Thank you Debbie!!!! I changed to the band just a half an hour ago. Now they have to rescedule me, which means even more waiting, but I feel I have made the right decision. You have said exactly what I have told everyone I know, just this morning. I am not at a point where I need to lose desperately. You have to work hard with the RNY after the first six months anyway, so why take more risk and lofelong body changes if I don't have to. Thank you so much! Risa

Hi Risa. I can't tell you which surgery to have either~I've seen success and failure with both. Either way its a lifechanging commitment that's required and as long as you're commited to a new way of life, you'll do great I'm sure! I don't know much about the bone density issue as I've not had to deal with any of that. As far as the tummy bulge and/or carbs, that's true for some no matter what surgery type you've had or no wls at all. When I was in my 20's and very thin I had the same problem and that was years b4 weightloss surgery~it just hits some and not others. I think as we get thinner we just naturally become more aware of our bodies and how they look~when I was at my heaviest I don't think I really would have noticed any extra tummy bulge b/c my tummy was always big. Now that my tummy is smaller, even the slightest difference is VERY noticable to me. As far as regain, I've seen it happen with rny and lap band so there's not much help in making a decision there. I wish you so much success no matter what surgery you have! It sounds like you are commited to this for the long haul and either option is no easy out~they both take hard work and commitment! Good Luck to You! Tracy B 328/150 5'9"

First off, congratulations on your upcoming surgery whichever way you decide to go. I can only tell you why I chose RNY over Lap-band. I am certainly not trying to start a discussion of which one is better, only why MY decision was RNY over band. I, too, wanted something that had a better success rate long term and could lose the weight quicker and a higher percentage of excess weight lost. RNY seemed to fit that bill. The other reason was that I read that in quite a few cases, a revision was done on lap-banders and they usually went to the RNY. Revisions being done because either they weren't successful with the weight loss or there were problems with the band itself. I'd also learned that the likelihood of band failure increased over time. Just like a belt on your car needs to be replaced, eventually so will the band. I'm only 14 months out, but my blood work, bone density test, etc. came out great. I'm diligent with my vitamins. I also have arthritis and I was showing signs of early osteoporosis some years ago due to a hysterectomy and incorrect dose of estrogen. I felt that RNY had just some malabsorption that I could control easily enough with supplementation. To me, it was worth the risk. Hope this helps. Linda

Bone density may be an issue no matter what surgery you have. or even if yo have no surgery. In the US 44 million people have low bone density, about 55% of the population age 50 and older. 1 in 2 white women will experience a fracture due to osteoporosis in their lifetime. http://www.medicinenet.com/osteoporosis/article.htm the vast majority of them have NOT had any sort of WLS. I have osteopenia, but I accredit that to the 42 years of bad nutrition before my WLS. I think many of the cases could also be attibuted to taking in inappropriate amounts and type of calcium. Tums for example have aproxamately a 5% bioavailablity of calcium even in non-ops. you would nneed about 50 of them a day to absorb the amount of elemental calcium a day that you need. and they have and antacid which further recduces absorption - even in non ops. Only you can determine which surgery is the best FOR YOU. take all factors into account and wthe lifestyle you can live with. as another poster said, I wanted, no, NEEDED, the permanence of the RNY. It as with any surgery is a tool, not a cure. the tool helped me get to the point I am now that I am physically able to do what I need to do to maintain my weight. I also felt the behavior modification aspect of the rny - aka dumping syndrome, would also give me a better chance. Many do well with the band, especially initially. If it doesn't work for you , it can bve revised to an RNY later. a big part of me wishes I had done more research on the DS pre op as well. It might have been a good alternative for me as well., especially with my fears of regain. (which is not happening at this point but I am always on alert for it to happen)

I agree with you that I also needed the dumping syndrome. I knew that if I was going to do something as drastic as WLS then I needed something that would "force" me to not cheat. This was my one chance to finally lose this excess weight and I wanted, needed, to do it right this time. I forced myself to learn to eat correctly and this dumping syndrome helped me in that regard. I am so glad I had RNY instead of the lap band. Someone very close to me had the lap band and she is now about 10 months out and has only lost about 45-50 lbs (25 of that was pre-surgery) and she has learned to eat around it **** cream melts). Maybe if she'd had the dumping syndrome, she might not have succumbed so easily. Who knows? I feel bad for her but only she can change, no one can do it for her. She might not have done very well on the RNY either but I truly feel that she would have a better chance if only because of the dumping issues. I too fear that I will gain the weight back and I'm trying to stay physically active and try very hard to eat right most of the time. I weigh myself daily, sometimes multiple times because of that fear. For me, weighing daily helps keep me in check. Willow, you've done very well and I applaud you in your success. Linda

I opted for RNY because even with just 100 pounds to lose, my surgeon said with the RNY that would be possible for me. (I actually lost 15 pounds more than that). But with the band he quoted only a 40-50% weight loss. For that little bit of weight I would lose on the band I decided on the RNY. I am so thrilled with my decision I can't tell you. It's changed my life. My eating habits are one of a normal person. I don't have any complications, and I'd do this again every 6 months again if I had to. AT the time of my surgery the band in my area wasn't a good option. Many had complications and many of my friends who rushed into having the band put in are now revising to an RNY. My daughter in laws parents had (each) the banding procedure done. Her dad has lost 86 pounds in 24 months and her mom just over 60 in 18 months. They don't have the restriction I do with the RNY and eat more/the wrong foods and have suffered. Their health problems haven't gone away as they haven't lost enough yet to help their diabetes and hypertension. Her port became lost in the tissue and she had to have another port put in - another surgery. Both are sorry now they didn't opt for RNY but thought the band was "less invasive" and didn't want their insides rerouted. At the time of my surgery, 5 years ago locally, the band had many complications and I didn't want to deal with more hospital stays and eventually going to the RNY anyway. You have to decide what you want to do - there are many successful lap band patients. For me RNY was the only choice and I'd do it again in a minute.

f I had the choice, I would have had the lap band. I am not dissing the RNY procedure. This is just common sense. This process is about behavior modification. If I had the choice to have behavior modification in a way that did not expose me to greater risks, I would choose the band. Believe me, after four years, you have to make the same choices that you had pre-op. I can eat as much as I want. The decision not to gain weight has come from modifying my behavior. I believe I could handle my old stomach now, but I do not have that choice. Good luck in your decision. To me it would be a no-brainer. You are a lightweight, as was I. If the choice is there for you, please consider the least-altering surgery. Once this is done, you have to live with it forever. HUGS. Christina

Risa, they both have their advantages and disadvantages. You have to decide which one is more suited for you. I chose the Lap Band, and am very pleased with it. Yes, I am losing slower than RNY people, but that's not bad, considering it may help with the loose skin problem. Also, statistics are showing that while RNY people lose weight faster, at the 5 year mark Lap Banders are about even. It seems that after the initial weight loss for RNY, there is a swing upward for many people. From many of the posts on this site, I would say that is true. A lot of RNYers post messages about how hungry they are all the time, after a year or so. I don't think I will have that problem with the band, because I can always get it adjusted. I chose LB because of the lower risk of complications and side effects. I don't have to worry about malnutrition, because I eat a very balanced diet. And if I really want a piece of cheesecake, I can have it without dumping -- even though I stay away from it! (I know, some people NEED the dumping to keep them away from sweets). If you are a sweets-aholic and a grazer/snacker, you might do better with RNY. If you are a carbs addict and/or a quantity eater, the Band will be great. I would lay out all the pros and cons for each one, and prioritize them according to your individual needs. That may give you a clearer picture. I think one of the most important things you can do (whichever one you pick) is to find a surgeon with lots of experience doing the one you want. I think that makes all the difference. Good luck, with which ever you pick!