Question:
Which Surgery to Have ---WHY??? --- HELP ME DECIDE
I thought I wanted lap band, but then the doctor suggested bypass, but said the decision was mine to make. Well, I can't seem to make it. I change my mind from day to day usually after reading horror stories about people throwing up or dumping or sliming--I didn't even know what some of those terms were three months ago! I need to lose about 90lbs, am 59, and have diabetes- type 2. It sounds like there are so many limitations on what you can eat. Which procedure has the least limitations? I will follow the program strictly, but want to make the right decision. Please help. I am in month 4 of pre op and need to make a decison. I am going to the hospital's orientation tonight for the second time to ask questions. I am so confused right now. — irish1214 (posted on April 22, 2008)
April 22, 2008
Only you can decide. I am 59, diabetes and Heart patient, DJD and metal
rod in my back and two knee replacements and I decided the Lap Band
4-16-08. I am almost a week out and I have had no real problems. The
protein shakes are the worst, there ones I have are really good but
sometimes I just can't get them down. I feel like I am failing but I am
down 8 pounds this past week so I guess I am doing something right. The
gastric was out for me because of other factors with my heart and I was
told the Lap Band was the best for me, I was scheduled for gastric but it
didn't work out and I figured it was God sending me a message that the Lap
Band is what I needed and I do not regret having the Lap Band. Good Luck in
which ever you chose. God Bless.
— dyates2948
April 22, 2008
I was 59 when I had RNY surgery. I needed to lose more than 80 pounds, so
I had the RNY. My mom has diabetes, and I knew I was a candidate. If you
watched the 60 Minutes program on CBS last Sunday, they had a segment on
gastric by pass surgeries. Diabetes went away in all of the 8 people
interviewed on the segment. The only real limitations are the amount of
food, and for some, a few select foods that cause them problems. There are
far more patients with no problems, than those that post with problems. As
with any surgery, complications can arise. Support group attendance,
participation in these forums, and asking your doctor any questions about
"possible complications" from surgery--all of these will lead to
the easiest transition from obesity. Yes, go to the orientation again and
ask questions. Hopefully you'll have someone there who can speak both about
lapband and RNY surgeries to address your concerns.
— Dave Chambers
April 22, 2008
I hope that I can help. I had a hard time deciding, and I spent three
years researching what to do and what doctor to do it with. What it got
down to the facts, I had two freinds about my size have the lap band. One
has done good, not great and the other lost 36 pounds over 2 years. He did
not like the feeling after fills and just did not maintain it well. The
other worked at it, but can get any more weight off and wants to lose
another 100 lbs. I decided on RNY because I had diabites Type II for 25
years. I read a resarch document about test on ratss and a test that was
being done in south aAmerica where they were curing diabites Type II by
just moving the 1st third of the small intestine that absorbs fat and
sugar. THat is what they do in RNY. I was told that since I was 62 and
Diabitic for 25 years there was not the same chance of a total cure, but it
would help for sure. I decided something was better than nothing. In less
than a month I was off 9 diabetic drugs, and 4 months later and almost 100
pounds lighter, I have a A1C of 5.6. That is non diabitic. I take no
drugs for diabities, blood pressure or colestroal, and never had more
engery. I would have a RNY all over again. I went to a lot of Support
groups and the happy people there were the RNY patients. Go for your self.
Ask where you can go. You will be welcomed before surgery and you can
talk first hand to the patients. The ones with the smiles are the RNY
patients. It is a tool. Dumping is if you are stupid and don't follow the
rules. I eat and entertain, go out and attent lots of parties, but I know
what I can eat and drink and I am glad to do the right thing for the rest
of my life, and I have just bought a lot more years. I want to get to 170,
a weight that I had in the 7th grade. I will get there before the first
year is up. I got about 75 more pounds to lose. CBS had a peice on RNY
and spoke to several patients Sunday night. If you missed it, send me a
email and I will send you a DVD I was again a lot of smiling faces so when
I saw them I knew they all had RNY's. Best of success to you.
--Bill
— William (Bill) wmil
April 22, 2008
Something to consider. 80% of type 2 diabetics who have the gastric bypass
reverse their diabetes almost immediately. That doesn't happen with the
lapband, because there is no bypass of the duodenum. Some people who have
the lapband and lose a significant amount of weight, can improve their
diabetes but not to the same extent the gastric bypass can. Good luck on
your decision.
— [Deactivated Member]
April 22, 2008
I went back and forth too to make my decision. I chose bypass and I don't
regret it. I read about all the problems too but for myself I haven't had
any.
I can eat anything in small quantities. As soon as I feel full...or start
thinking "this doesn't taste that good" then I stop. I've never
even thrown up...however I think I get a very slight dumping sensation. To
be honest though, this is what keeps me from eating more. If I felt great
and not full and was totally enjoying my meal, why would I stop eating?
Know what I mean.
I still cook and entertain and go out on vacations and to parties. I enjoy
everything just like before...the only differenc is what I eat. And
mentally this HAS been hard to adjust to. When I'm feeling hungry and
think about the good food that is coming my way, then actually start to eat
it's kind of a sad feeling that I have knowing I'm not going to be eating
much of it. But once I get that full feeling, after a couple of bites,
then I really don't care anymore. Does this make sense to you?
You have to be totally ready to give up your old relationship with food and
start a new one. My 60 lbs. less body in 3 months more than makes up for
my mimi feelings of deprivation.
Good luck MS.
— cjjordan
April 22, 2008
I have 140 lbs to lose. I decided Lapband. I totally nixed gastric bypass
a while back when I met someone who had gained his weight back, plus more
and weighs over 400 lbs now. He can only seem to eat red meat and candy,
anything else he gets sick on. And the thought of haiving my body
permanently rearranged, didn't like the thought of that. Gastric bypass
has some advantages. You do lose a lot of weight fast. But what are you
giving up for that? I've lost 38 lbs since January. I'm a type 2
diabetic. My longlasting insulin has been cut by over 70%, my short acting
at least 50%. I was on 3 different types of blood pressure medication (I'm
43) to me that's to much. I'm sure my grandma was rolling over in her
grave:o) I am off of one of my bp medicines, one has been cut in half and
the other is going to be cut soon. Where it would be nice if I could have
gotten off all that medicine over night, I didn't add all that medicine or
weight over night. A friend and I had no post op pain to speak of. They
did give us pain meds, so I took them just because I wanted to be sure I
wasn't in pain. Another friend had gas pain. You have to follow the diet
and of course only use the band as a tool. And yes you have to get use to
listening to your body. Food restrictions are that bad after the first 3
weeks. I haven't got sick (yet) and hopefully won't. I have found out
that I can't eat swedish meatballs or peanuts right now because they
actually make me fell like I have the flu. You just have to make the best
food choices. Yes I've had chocolate, PMS, but just a little sample size.
THE DECISION TO HAVE SURGERY IS THE BIGGEST DECISION, you've made it past
that. Lap band isn't as invasive and down time is maybe 5 days a lot of
people less; and isn't as expensive. BUT you do lose a lot faster with
gastric. I am so thankful that I did get lapband. Have you gone to any
support group meetings for the gastric or lapband, what about seminars?
Good luck! Whatever decision you make will be the best one.
— jct001
April 22, 2008
SORRY, I meant to say Food Restrictions AREN'T THAT BAD.
— jct001
April 22, 2008
I never considered the lap band because it seems like people aren't losing
enough weight on it. Have you considered VSG? It's supposed to help
and/or cure diabetes too. I think that is what I'm going to do but will
admit that I haven't ruled the RNY completely out. Good luck!
Kim
— GlitterGal
April 22, 2008
Those are not the only surgical options available to you. They may be the
only options that YOUR surgeon performs or that your INSURANCE will PAY for
but there are other options. If I were you, I would check out ALL of the
options available to me and make my decision THEN. I would not allow
INSURANCE be the deciding factor. This is something that you are going to
have to live with for the rest of your life. If the surgery that you want
is NOT covered by your insurance, you may want to consider paying for it
YOURSELF. People think NOTHING of $20,000.00 for a CAR that they will
DISPOSE of in 7 to 10 YEARS at the most. THIS is something that will
effect your HEALTH for the REST of your LIFE. It is often possible to
BORROW the money to get the surgery that you may want done. I have had the
Vertical Sleeve Gastrectomy done and this surgery has been shown to have
the LEAST rate of complications or side effects to ALL OTHER weight loss
surgeries. It is COMPARABLE in effectiveness to the Gastric Bypass at
weight loss without the issues of dumping and malabsortion. I went from
using 70 to 80 units of 70/30 insulin with an occasional boost from regular
insulin and four pills of Glucovance 5/500 a day to using NO diabetes
medications in just THREE WEEKS! If you want to get more detail on your
options just go to my profile page and check out my blog. Look for my post
called Surgical Comparisons. If you don't find it on my profile page when
you first check it out look into my archives in the March archives. I have
a fairly comprehensive comparison of the main types of surgeries available
in the US today. There are also links to videos and other resources that
you can use to find more information about the different surgical options
available today. Check out my profile here:
http://www.obesityhelp.com/member/hubarlow/ .
I hope this helps,
Hugh
— hubarlow
April 22, 2008
I chose the DS because I Wanted a surgery that has the least chance of
long-term re-gain, is BEST at curing
Diabetes (98%+),
removes much of the hunger hormone Ghrelin, NO DUMPING, NO MARGINAL ULCERS
and NO STOMA / STRICTURES, I chose the Duodenal Switch surgery.
Do investigate all the options. I wanted my system to still operate the
same which is why I chose to keep my pyloric valve intact with the DS.
DuodenalSwitch.com
With the DS: there is no stoma, so no stoma strictures; there are no
limitations (other than volume) against drinking before, during or after
meals; 80% of ingested fat is malabsorbed, allowing liberal use of eggs,
butter, mayonaisse, healthy oils, marbled meats, cheese, etc., in the diet;
98.9% of type II diabetics are CURED of this devastating disease, with data
showing stable cure over 10 years out; there is the best average weight
loss and most durable (average 76% excess weight loss going out 10 years)
of all of the bariatric surgeries. That's why I had a DS!
— SameButDifferent
April 22, 2008
Food restrictions are not that bad with the lap band. The only thing I have
really had to stay away from is soda. But don't let this be about the
foods. If you are going to decide which surgery to have based on the food
you can still eat then you might as wekk quit now. It is those same foods
that got you to this point point to begin with. This surgery is about a
lifestyle change and even though its scary it is a chance to do-over. Dont
let the food ruin that for you. Now before you get upset at me for being
harsh you should know I was going through this before my surgery too and
someone told me what i just told you. I hope it helps.
— Rachelena
April 22, 2008
< Yes I've had chocolate, PMS, but just a little sample size> .This
is why I did not have the Lap Band. I was a sugar addict. I could NEVER
stop at a little sample size. Some people have awesome willpower but I was
not one. That sample size would turn into one every half hour for the
entire day! LOL! The RNY changes your body chemically, hormonally. I
don't have the cravings now. I never eat concentrated sweets. I knew when
I made the decision to have surgery what I was giving up. I do not miss
it. I have gone through birthdays, Christmas, Halloween, Easter, and yes,
PMS, without sugar. Swiss Miss Diet coco is 25 calories, no sugar and
plenty chocolaty. Which surg you choose is a personal decision based on
what you know YOUR eating habits are. If you are a big sweets eater, in
all honesty the Lap band will not have good lasting results. If you just
like to eat a lot, then the band will probably work. Just feel good about
your decision. Also consider, if your insurance pays for a particular surg
and it doesn't work, good luck getting them to pay for another one. Be
confident about your decision whichever it is. When you go to the hospital
orientation, ask about sugar addiction (if you are one) and the LapBand vs
RNY. Ask if the surgeon will do the surgery or will residents be in there.
Ask if it is laproscopic. (You should be a very good laproscopic
candidate if you have 100 or less pounds to loose.) Ask about the hormones
Gherlin and Leptin. Also I would consider "throwing up" or
"dumping" or "sliming" part of the learning curve; part
of your training; learning what you can eat and what you can't, learning
that yes you really do have to chew, some meats are very hard to deal with,
and that your tool, whichever it is, really is working! I have
"thrown up" maybe 3 times, all on different meats. And throwing
up is not like you think of it now, it is a little throw up like a little
baby spit up. (I had RNY by the way...almost 1 year out.) :0D Good
Luck!!
— MAG
April 22, 2008
I started off thinking lapband and swithed to RNY. I did not want to fool
w/ fills and thought it would be too easy to cheat ...chocolate melts in
your mouth! Glad w/ my decision. I do not dump but have lost about 100 lbs
in 7 months. If I had diabetes - there would be no question. I thinl the
cure rate for type 2 is even higher than quoted...more like 98%.
— JTR
April 22, 2008
FYI - The lapband is only a tool to help you lose weight. If you don't use
it correctly, it will not work.
— Pam-TX
April 22, 2008
Dumping, sliming and vomiting, etc. are all signs that you're not following
directions. It's a life change - you have to eat way slower, avoid things
that make you sick (meat still bothers me - I'm 8 weeks out) - avoid
sugars, etc. If you follow the doctor's orders and really commit to making
a life change, you won't experience any of this. Once I ate too quickly
(you forget) and as a result, I vomited. I learned my lesson quickly. I
have had no problems since. I think RNY is like hitting a home run. It's
all about the commitment. I'm two months out and never want to look back.
Also, 60 minutes had a special this past Sunday about RNY and the effects
on Type 2 Diabetes and it was such a positive reinforcement for me to see
this. See link to the show, attached. Good luck with whatever you decide
and make sure to follow doctor's orders!
http://www.cbsnews.com/stories/2008/04/17/60minutes/main4023451.shtml
— Donna_in_PA
April 22, 2008
Congratulations on your decision on improving your health! My mother and I
are both post-op RNY. When we first went to our doctor's seminar, we were
both going to do lap-band. After hearing the information, we both changed
our minds about which procedure to have. One of the statistics that our
doctor gave was that with lap-band, you can expect to loose 50-60% of your
excess weight, with RNY, you can expect to loose 70-80%! Also, my mother
is Type 2 and the idea of leaving the hospital totally off her diabectic
meds and insulin was enough in itself to help her decide. I agree with the
previous posters that it is a life change. I am 2 months post op and have
no complaints. You learn to listen to your body, (and if you don't, it
tells you about it!). I haven't had sugar in 2 1/2 months and I can
honestly say that I don't crave it. Good luck with your upcoming surgery
and hope this helps.
— pkwhite64
April 22, 2008
Hi. I had RNY last May and also work in a WLS clinic. Here are my
thoughts. RNY is the definite choice for someone who doesn't have much
self control, who can't choose the right kinds of food, who wants a
"built-in" mechanism to keep them from eating fatty foods or
sweets. Lap Band is the choice for someone who can choose the right foods,
who can be happy with a taste or couple bites of bad foods, but has a
problem controlling their portions. I am 33 and weighed 353 one month
before surgery. I lost about 10 lbs when I was put on the prep diet before
sugery. I was on 3 rx's for diabetes, 2 for hypertension, and 1 for
depression. I left the hospital after surgery with only my
anti-depressant, which my surgeon suggests we stay on for at least 6 mos
post op because of all the changes our bodies go thru, both physically
& mentally. I didn't have any problem knowing what the right choices
were when I ate, I just couldn't choose those types of foods. I constantly
ate sweets, fast food, pasta, etc, all of which I knew were not good for
me, especially for my diabetes but I just couldn't stop. Now if I eat any
of these types of things, I get dumping, which the best I can describe that
is "I want to die!" Henceforth - I DO NO EAT THOSE FOODS
ANYMORE! HAHA. To date, I have lost 128 lbs and I know I made the right
choice for me. I am enjoying life, enjoying my daughter, I even enjoy
PUSH-MOWING my yard, and I have a big yard! Only you should make the
choice and decide which surgery you can live with! Good luck on your
journey and I wish you all the best of luck!!
— pam2007
April 23, 2008
I would highly suggest you keep researching, attend support groups that
have all kinds of WLS patients and ask them about their experiences. Keep
going to seminars and gather as much information as you can to help you
make the best decision.
Surgeons seem to be committed to either Bypass or LapBand and when you
listen to them, each is convincing that his/hers is the best.
No matter which one you decide on, the biggest thing I can stress to you is
that you can cheat your tool with any WLS. If you do not make a life long
committment to change, you will not be successfull.
I am a LapBand patient and I get a little frustrated when I hear people
can't lose or end up losing very little and blame their bands. I have lost
135# quickly because I am dealing with the emotional issues with obesity,
make my appointments and am diligent with my fills/unfills to get good
restriction and exercise. That being said, I could put a Big Mac in a
blender and still get it down so.....
Good luck to you,
Dawn Vickers, RN, BLC, CLC
— DawnVic
April 23, 2008
Everyone needs to make their own decision but my experience is that I was
on four metformin (500mg)=total of 2000 a day and my next step was insulin.
Four days after my RNY I had normal blood sugars and 6 weeks later my blood
sugars are in the 85-90 range! I was told by my surgeon that RNY was the
most effective procedure for those with diabetes.
— JMEwing47
April 23, 2008
Please see the post from Bethany Berka, she asked the same type of question
and there are a ton of responses, mostly for the RNY, but check it out and
see, good luck to you.
— noboat4u
April 23, 2008
It is a difficult decision to make. I too vasilated between RNY and Lap,
but have chosen RNY. If you do further research on the bypass procedure
and its effects on Diabetes you may have a clearer idea. If I were you and
had Diabetes I would choose the RNY due to the fact that it actually cures
it. I am not aware that is the case with Lap Band, although it doesn't
carry the risks of RNY. Hopefully this has helped.
Sue
— yankeefan75
April 23, 2008
The less dramatic lapband is no guarantee of a smooth/easier recovery. A
lapband woman in my support group required lapband replacement surgery
within 9 mos and now! needs to go back in for RNY. An endoscopy (because of
constant pain) revealed serious stomach acid-related problems. Other
lapbanders in my group complain about the fills, etc. I am 55, was diabetic
and am ecstatic that I chose RNY Oct. '07. I stopped all diabetic meds
before surgery and have never needed them since. My A1C is 5.5 (had been
7.8 before surgery). Have lost 90 lbs with 10 more to go. The most critical
decisions are choosing the best doctor (with good support services) and
getting comprehensive screenings of all vital functions. Even though this
is dramatic surgery, it is no "get out of jail free" card. The
first couple of months, the weight fell off. But since, I've had to make
sure I'm eating correctly (cheating still shows up in lbs) + work my butt
off exercising (6 hrs/wk intense cardio + weight lifting 3 x's/week). After
this many years, I KNOW I have an eating problem. So choosing a lapband
because it might be reversible doesn't make sense. Good luck!
— Cathy 1.
April 23, 2008
I had the LapBand 3 wks ago and am happy with it so far. You mentioned that
you have diabetes. I saw a segment on 60 minutes Sunday night about Gastric
Bypass. They had 8 people on that all were diabetic before surgery and 4
days post-op they were off all meds and their diabetis was gone. They
explained that the bypass surgery bypasses the duodenal area of the stomach
and stops the diabetis. I also read an article i found here on the boards
about a wk ago explaining this. You might discuss this with your Dr. Also,
i'm sure you could see that segment from 60 Minutes on line. Good luck and
God bless you
— Kristi H.
April 23, 2008
WOW, this questin keeps coming up. I just answered someone else about this
same subject.
I had Bypass surgery 0n 09/24/07, I've lost 115 to date, after starting out
at 350 lb.
My suggest is to buy a book called "WEIGHT LOSS FOR DUMMIES". If
it doesn't have the answer, it may trige some questions to ask your
surgery team.
Good luck.........this will change your life, at least it did mine.
— CMFitzpatrick
April 23, 2008
Have you considered the DS? Come visit us on our forums!
— M. !!!
April 23, 2008
Like the previous responder said it is your decision to make. However, I
can share with you what I learned about the procedures in the beginning. I
am almost 3 months out of having the RNY. And I love it. I have 57 pounds
and can eat anything. I do not eat any sugar and I choose very few carbs
like I am supposed to. I also have never thrown up. I did coime close a few
times but that was because I knew when I was eating that i was eating too
fast. Other than that i have had one complication and it wasn't a big deal
at all. I had a stricture where your esophagus begins to close on itself. I
had it easily repaired and am fine since (this can happen with any of the
procedures). In the beginning I wanted the band. My surgeon informed me
that there could be several things that may happen. The port where they
fill it could become infected and painful. The tube connected to the port
and the band can corrode and need to be surgically replaced. The stomach
can also flip on itself and need to be sugically fixed of not having the
band completly removed. Therefore, leading to weight gain and probably
needing the Gastric bypass anyway. She also told me that they take out more
bands than they put in. That is why i decided on the RNY. I figured I would
skip the middle man and go for the RNY. I love it!! It was 10 times easier
for me than my c-section. There are complications from the RNY also.
Evrryone is different. I also made a decision based on what i learned from
reading other OH members profiles and responses. That was probably the
biggest help for me. I have also heard from other people that have the band
and it has worked great for them. It's up to you. I just wanted to share
with you what i had learned.
— Sillyguts
April 23, 2008
my opinion is to have the bypass. I would rather have the restrictions. If
you are looking for less restrictions you are not serious enough to lose
the weight.
— nascar_angel_3_2003
April 23, 2008
It should really be a combination your decision and your doctor/surgeon's
recommendation. Mine made me really analyze my eating habits (my problem
was more portion control than sweets and grazing), so that a stomach
reduction was my best option--but it isn't for everyone. You have to stop
thinking about what's easyist because that basically means you're already
looking for ways to defeat it. You really have to commit to changing,
period--the surgery is a tool, but it isn't the solution. You still have to
give up your habits and start over. Best of luck.
— suezahn4me
April 23, 2008
I chose lap band. I was/am a bulk eater, not a sweet eater. Did not need
dumping. I had surgery 1 yr ago, I have only "Slimed"/PBed once.
small bites, chew well, not eating a more solid form of food than you can
tolerate all help. I have lost 75# in the first year. Not as fast as
bypass. I will continue to lose for up to another 2-5 years if need be. The
band will be there forever if I need it.
For me it was the right choice.
— Donna O.
April 24, 2008
Short and sweet! The DUMPING SYNDROME is associated with RNY. There is no
DUMPING SYNDROME associated with banding (I am told). The DUMPING SYNDROME,
or rather the avoidance of it, is what has kept me on track with weight
loss and continues to help me maintain my weight after successful weight
loss. Also RNY requires no post-surgery maintenance fills, as does banding.
I highly recommend RNY.
— [Deactivated Member]
April 25, 2008
I chose the VSG as a 'happy medium' to the lapband and rny. It is only
restrictive (like the lapband) so you avoid the problems of malabsorption
and such...but it doesn't leave a foreign body inside you that requires
frequent maintenance (e.g., fills and adjustments). It can't slip, and you
don't have to worry about dumping or sliming or stritures in the stoma
because your own pyloric valve remains intact. The 5 year weight loss for
the VSG is just below the RNY, but above the lapband. My doctor's office
has been doing the VSG for about a year now, and they say the 6 month
results are running at about 60% of excess weight lost at 6 months. That
is as fast as the RNY. Also, since I am self-pay...the cost of the VSG is
just a little higher than the lapband. My doctor (Dr. Trace
Curry...www.thebanddoctor.com) charges $14,700 for the VSG, including the
pre-op medifast diet and 2 years of follow ups.
Good luck finding the surgery that will be right for you!
April
— abeeba
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