How did you make a decision which surgery to get?

I decided to come to the veterans and see how you made your decision on which surgery to have. What tipped the scale one way or the other for you. I have not had the surgery yet and thought I had decided on the bypass and now I am not sure if I will do that or the lap band. I am a sugar/carbaholic and am fearful that if I get the lap band I will make unhealthy choices and fill my pouch with carbs. I was told by my physician that with the gastric there is a 50/50 chance I won't be able to tolerate the carbs and fats. I spoke to a friend that had the lap band and she said what her mind up (she is an RN) is that if she were to get a wasting illness like cancer that you cannot reverse the gastric if needed to gain weight. I am very interested in everybody'sideas and what made your mind up. Thanks so much. Lynn

Hi Lynn. I guess its a personal  decision and there's really no wrong answer. I went with RNY b/c that's what I felt I needed to be successful long term. I did a ton of research and talked with anyone and everyone about their experiences. I not only researched the different surgeries, but did extensive research on my surgeon. I completely trusted him and this is what he also felt I needed to do. I wish you so much luck with your upcoming surgery whatever way you decide to go!!!!!

Thank you so much Tracy. I am excited and nervous. Lynn

Hi Lynn, My insurance company had a large part in my decision making.  They would only approve the VBG and the RNY.  After much research and coming to this website, I decided on RNY.  The Lap Band wasn't an option back in 1999 when I began to research WLS.  Good luck and many blessings to you in whatever decision you make. Char

Hi Lynn, I decided to have gastric bypass surgery after alot of reading and asking questions about both surgeries. Made a list of pros and cons. Then I thought about the length of time it might take me to lose the excess weight with either procedure and looked at my eating habits. After all that I made my decision for RNY. I have not had any regrets.  Whatever choice you make should be your own. People are successful with both surgeries, but we all have to learn new ways of eating in order to be successful. It requires work and determination and is not easy , but the rewards are well worth the effort. This is a lifelong commitment to follow the program we are given and with RNY you need also to take certain vitamins for life because of the malabsorption issue. Best of luck in  your weight loss journey. Sher

Your friend the nurse is wrong. Revisions after RNY are possible and the bowel can be reconnected if there is a need to gain weight. When picking my WLS, I didn't look at all the happy cheerleading posts (all surgeries are successful in some people), but went to the national library of medicine (www.pubmed.com) to find out what the research showed the odds of success were over time. The number one issue for me was long-term success, because I've been on too many diets and failed too many times. I had diabetes, so there was no time to mess around. i  had to lose it and keep it off. There are a lot of people who lose all their excess weight with each of the three main procedures. You might be one of them, but in most people there are risks of regain.  In the New England J of Medicine, Sjostrom reported the long term (10 years) weight after gastric bypass.

'(Average) maximum weight losses (not excess weight, total weight)  after 1 to 2 years were: gastric bypass, 32%; and banding, 20%. After 10 years, the weight losses from baseline were stabilized at 25%, and 14%, respectively."   

If you do the math, an average weight for someone who weighed 300 pounds before GB was 200 pounds at year 2, and 225 at 10 years.  [For banding the average weight would be 240 at 2 years and 258 at 10 years.) 

This study didn't report the long term results with the surgery I had (duodenal switch), but  Paradis recently reported 2 year data: "2 years after DS, patients had lost 50% of their body weight." Again, not excess weight, total body weight. So that 300 pound person before DS was averaging 150 pounds two years after (no 10 year data reported on DS that I could find). I'm at almost 3 years and I lost 50% of my pre-surgery weight, and am maintaining that loss without  much effort.

The average RNYer maintains a loss of 25% of their preop body weight during that 10 years. With the band, the average person had lost 15% after 10 years.  That's much better than diet and exercise (Sjostrom reported that was plus or minus 2% at 10 years). These weight losses were enough to improve their risk of death, so that's a good reason to chose either one.

Of course, these are just averages and people who follow all the rules can exceed the average. What's enough weight loss for you? This board does not always represent the average success, since those who fail are less likely to stay around than those who succeed or are still trying to succeed.  Keep asking questions.. good luck.

  

Hi Lynn: As everybody had said... only you know which surgery is right for you.  One thing about the Lap-Band is that you may also find that you can't eat a lot of carbs in the form of bread, pasta, and rice once you have signficant restriction.  There was a study done years ago that showed sweet-eating is NOT a predictor of failure with the Lap-Band.   (http://www.springerlink.com/content/fq17265127121g1m/) Also...if you do dump with the RNY... sometimes those effects lessen as time goes by. To be successful with any WLS, you need to make changes that will last a lifetime.  Your surgery will make it easier... but you can out-eat any WLS.  For me, I went with the Lap-Band because I wanted the surgery with the lowest complication rate at the time. (These days, I think that VSG, Lap-Band, and RNY are all about the same in the hands of an experienced surgeon).  I knew I wanted to have kids, and I didn't want to worry during my pregnancy regarding nutrients.  I didn't have type 2 diabetes at the time (or any other comorbidities)... so the Lap-Band seemed like a good option.   It also gave me the option of super easy reversability should a better surgery/solution come up down the line. If you are looking at both the Lap-Band and RNY... you should also look at the VSG (sleeve gastrectomy) and the DS as well. (MGB too) Be sure you've checked out all of the surgeries so that you're comfortable with your decision. :) Good luck! Only you know which surgery is right for you.

LapBands were not being done in the US when I had chose back in 94. BUT my docs had done trials in 1991 and by 1994, none were still intact. As time has gone on, we've followed bands done out of country and then of course, in country. Am certainly not saying those done elsewhere were bad in any way, so don't read that into it.

But based on what I've seen, I would still choose my RNY over anything else I've seen in 13 yrs.

Altho I've had 3 weight gains from sugar (it doesn't take much to gain wt!), at least I have a stopper for gaining it FAST (still get sick if I eat much at one time). And if my brain is turned on, of course, I would not eat THE FIRST BITE. I think because mine is RNY, I had the ability to re-lose the sugar pounds, because as long as I eat according to my plan (4 small meals, no grazing, no milk and UH, NO SUGAR), I will hold my wt or so it still appears.

I tend to think of an RNY as a more permanent solution. I have considered when I'm older (MUCH older), will I need a feeding tube? Will some ill-guided medical professional think I need way too many calories, not realizing that just sitting candy near me will add weight? I don't know. I know what it takes to make me as nutritionally sound as I am, and I also don't know anyone else who can keep me that way but ME. That does worry me. But yes, a tube could be inserted if someone found it necessary to fill mem with empty calories.

All that said, I do know bands who have lost 100%, and a few who have kept it off, tho not many 5 yrs out with their original band still intact.

And then the final thing is that those who are successful have had to work much, much harder for their success than I have, as far as "dieting" and exercise. Iwould not have been as successful if I'd had to work THAT hard. I know me. I've had to supplement more diligently, but I can do that. I never had trouble putting things INTO my face. It was keeping them out that was the problem.

Read, read and read some more. Check out the boards on here for all the surgeries (well at least your top 3) and read them daily. Learn about the struggles, the victories...etc. Read the revision boards. Read profiles and webpages.  I can understand you wondering about the lapband and sugars because yo are right, I tend to read alot of those lapbanders who still have issues with sugars and carbs.  For me, I guess it was that i wanted a "more permanent solution" and chose roux en y. I didn't want to worry about fills/port issues as well nor taking anything out of me and replacing it down the road.  For me, RNY was the happy medium between lapband and duodenal switch.  I was fairly confident that with a tool, I could get the weight off. It is a very personal decision so you will have to grapple with that yourself. Just read, read and read some more. Talk to those with failed surgeries too. Good luck on your decision, Dawn