Which procedure?

mddomain

Hi, everyone! I am in the research/prep stage of the whole weight loss surgery process. I have had a consult with one surgeon, and I am trying to get in to see another, just because this is such a big decision I don't want to just go with the first doctor that was recommended by a friend. I am 39 years old, 5'3" tall, and I weigh 281 pounds with no comorbidities. I have never had any other surgeries except a c-section almost 11 years ago.

Before my consult with the surgeon, I was thinking I was interested in either a band or the sleeve, but after the consult, I'm leaning away from the band and more toward sleeve or bypass. Assuming all three procedures are represented in this group, I'd like to ask how you all arrived at your decision about which procedure to have. I know there are pros and cons to each one, and I just keep flip flopping back and forth in my mind between them. Any insight you guys could offer would be much appreciated!

Agate69

I was all set to schedule the band i the first year it was available at the univ of MN. After talking with their chief of surgery, decided to wait. Just did not relish the idea of multiple appointments to try to get the right fill. 2009 comorbidities appeared rather suddenly. 5'3". 285 pounds. Visited an information group with a surgeon that was in a center of bariatric excellence. Set up consult. He pretty much decided which procedure he thought would give the best long term results. He really stresses that it is but a tool and it was up to me how to use it RNY done Oct 2010. Comorbidities gone or in remission. BEST DECISION I EVER MADE, but it is a personal choice. Research is always increasing Data continues to unfold. I actually enjoy using my tool, and could not be happier.


Keep asking you will get to YOUR answer

Agate69

Hi, everyone! I am in the research/prep stage of the whole weight loss surgery process. I have had a consult with one surgeon, and I am trying to get in to see another, just because this is such a big decision I don't want to just go with the first doctor that was recommended by a friend. I am 39 years old, 5'3" tall, and I weigh 281 pounds with no comorbidities. I have never had any other surgeries except a c-section almost 11 years ago.

Before my consult with the surgeon, I was thinking I was interested in either a band or the sleeve, but after the consult, I'm leaning away from the band and more toward sleeve or bypass. Assuming all three procedures are represented in this group, I'd like to ask how you all arrived at your decision about which procedure to have. I know there are pros and cons to each one, and I just keep flip flopping back and forth in my mind between them. Any insight you guys could offer would be much appreciated!

From my best understanding, the % of bands that fail! or need revision, is too high to consider. A foreign body or two in your body not what I wanted. I did not want the option of slower and ease to work around.

annwyatt69

I had the bypass, though I was leaning toward the sleeve more. My surgeon and I chose the bypass for me because of my health issues--type I diabetes on a pump, high cholesterol, high blood pressure, asthma, sleep apnea, hypothyroidism w/nodules, etc. I was 5'5" at 246 and was in the early stages of kidney failure. The bypass was a better choice for me.
I lost all my excess weight w/in 8 months of surgery. I have had NO complications--never threw up even once and have NO dumping. I am probably an exception. My health issues have improved dramatically. I am down from 155+ units of insulin thru my pump per day to under 25 units. No more sleep apnea, cholesterol is perfect and so is blood pressure. No sleep apnea and packed up the cpap machine 3 weeks after surgery.
The downside of gastric bypass would be that vitamins are essential for the rest of your life. I honestly haven't seen any other downs with it. I would have chosen gastric bypass over any of the others in a second. I do believe that with no co-morbidities the sleeve is a great option, though.

dward59

My thoughts for what they are worth:

I had the VSG at my surgeons recommendation, not that I had a lot of choice. These are the reasons:

1) We have moved a lot in our careers. Finding another doctor to fill and care for Band fills would be difficult at best. The inability to eat certain foods also was a deterrent for LapBand.

2) I was actually too obese to even be considered for RNY. The surgeon told me that I had to have VSG. However he also said that studies so far show little difference between losses with those on VSG vs those doing RNY. He said that if I stopped losing and wanted to consider the RNY that option was still open to me in the future.

3) My wife and I talked it out (she had the surgery as well at the same time I did) and we thought that leaving the stomach connected at both ends sounded a bit less invasive. Not to say there couldn't be problems with either surgery, but our rationalizations pointed us to VSG.

I'm sure someone who has had the RNY done can give you their thoughts better than my suppositions.

Either way you go, please listen to your doctor when he tells you this is just a tool. It will still take a lot of hard work to get to your goal. But I know without this tool I would not have lived too much longer and would not have enjoyed life as much as I am now. In some ways, I wish I had been brave enough to look into this procedure, or either procedure years earlier. If this tool is one you really need, then kudo's to you for taking the step now!

sleepingarby

I am scheduled to have the band procedure at the end of this month. I also considered the sleeve. I finally settled on the band as opposed to the sleeve for the following reasons:

More personal accountability: Because of the high "failure rate" as they call it, I had to think long and hard about how I felt regarding my own personal accountability. Diets don't fail. People fail to follow diets that promote weight loss and maintenance. I want to have the accountability but have the assistance. For me I view it like walking a tightrope. I want to do it myself but I still want the safety net. After all the "failure rate" is definitely higher without the safety net.

More follow-ups required: This again goes back to accountability. If I go back to my doctor every 6 months for check-ups and adjustments it means someone else is looking. I will not be able to hide from their scale even if I should decide to hide from my own and fibbing about exercise can't really happen, it will be obvious if I have done my part of the work.

Flexibility: Since this is an adjustable band I can affect the rate of loss. If I fall off the wagon, and adjustment may give me the kick-start to get me back on. We'll see if that prove to be the case. However removal is also an option making it not a permanent change physically. Fast-forward to when I'm 70-80 years old. Maybe it would be time to say good-bye to the same nutrition goals. Many older persons lose their appetite as they age anyway. What if I need to need to make that transition? I will have that option. Or what if a newer scientific discovery can find the root of obesity and we can all take a supplement that cures the "peckish munchies". OK that's not really likely, but hey who knows.

Anyway, we shall see if I can beat the odds of "failure" if I can maintain an overall loss of 30% of my excess body weight can I really call that failure??? It's better than the frustration of absolute failure.

On another note, my requirement for weight loss pre-operatively was 11 lbs….I have lost over 30. Am I motivated? Yup. With or without surgery, I have decided to lose this weight, but I still want the assistance.

Tristaan

I chose RNY mostly because of the "no return" factor (well relatively). I'm 41, been heavy since puberty and figured if I was going to have surgery I was going to make sure there was no going back. I had started to develop comorbidities and I knew at this point in my life I was headed for a shorter and much more miserable existence if I did not make a definitive change. After talking to my surgeon and going to intro support groups, I was under the impression that the sleeve has a higher failure rate. In fact, my surgeon said she does more surgery to take them out nowadays than to put them in. I made sure I went to a Center of Distinction, and chose a surgeon who has several hundred RNY's under her belt over the past 15 years. I read all of her reviews from patients, not one negative comment. So, I figured I could trust her advice. I had surgery October 28th and am down almost 50 lbs. I've cut my BP meds by half so far, no asthma symptoms, apnea episodes are down, and I feel much better. I am still learning to eat differently, and the vitamins can be a pain to take - but I'd rather take vitamins than medications any day.

stroynaya

I had the RNY. I knew from the start I didn't want the band. Just not comfortable with the idea of installing a foreign object in my body. Decision reinforced at the initial info session when I heard the stats on long term success. One reason I chose RNY over sleeve was long term (decades) stats. Sleeve is still new and long term stats on success and complications aren't known yet. Finally, I knew or knew people who knew several successful RNY patients so that also influenced my decision.

garber6th

I chose the sleeve for a couple of reasons. For one, my surgeon recommended it, he said it would be the best option for me because bypass might have been hard to perfom at my weight at the time. Also, I chose the sleeve because I didn't want to deal with mal-absorption issues. I also felt that I didn't want a procedure that changed how my body processes food as much as the bypass does, the whole re-routing and pouch situation kind of freaked me out.

I am 3 months out from my sleeve surgery, I have had no problems, and I feel amazing.

bikrchk

I chose the sleeve over R/Y because I didn't want the malapsorption issues present with R/Y, I had 90-100lbs to lose and was not diabetic.

The band was not even a consideration. Too high a % of problems to consider. I've personally known 4 different people who had it with issues. One had to have it removed when a laytex allergy was discovered. One had it revised to to R/Y because it made a "train wreck", (her words, not mine), of her guts, and one who had it revised to a R/Y because it prolapsed. The one person I know with a band who hasn't had it removed, initially lost weight, but then gained it back plus some and still has issues keeping food down even though it hasn't been filled in over a year. No foreign bodies for me!

The sleeve has turned out better than I'd hoped. The procedure its self went well, I never took pain meds and was back at work the next week. Now three months out, I'm down 55 lbs and can eat small amounts of whatever I choose, though I stick to protein. Off pre-op meds for BP and asthma, I exercise at least 5 days per week and LIKE it. Never thought that would happen!

grim_traveller

I would not recommend the band to anyone. Do extea research first. Check out the forums on Obesity Help for the number of people with major complications from the band, who end up having surgeries to remove it, and revise to VSG, DS, or RNY. There are fewer differences between VSG and RNY. The most significant is that those with acid reflux should not have the sleeve. There are serious problems for acid reflux and VSG.

I had RNY in August 2012, and could not be happier.

sashahanrahan

I weighed out all the pros and cons and to be honest, because I was self-pay it came down to cost. At my clinic, the sleeve was half the price of the bypass. I had the sleeve at the end of November and have had no complications.

My mom had gastric bypass four years ago and has had numerous complications including gallbladder problems (and consequently removal), blocked bowels, and nutritional deficiencies.

Of course, most of these examples are anecdotal. But I hope you feel like you can make a more informed decision.

Tristaan

*correction - I said 'sleeve" when I meant "band" as far as surgeon saying she removes a lot of them. They are two totally different things so I didn't want to put wrong info out there.

CynthiaGuinn50

I'm 5 yrs out from RNY and I weighted 292 and lost 90 lbs before the first year was up and have kept that off. But have not made it to the doctor's goal which was 160 lbs with being told I would gain 20 lbs back when I hit my lowest. I went in with the mind set of having lap band but because of my health issues being insulin dependent diabetic, high cholesterol, severe asthma, sleep apnea and was on oxygen. Both my parents died at 60 & 64, the doctor said I was having RNY because if I didn't I was going to live a short life too. Even though I vomited a lot in the first 6 months, had strictures I would do it all over again. I still have all the same health issues as before but not as bad, didn't cure my diabetes like I was told it would and still have to take the medications. I do have to take Morphine now twice a day because of pain in my lower back, arthritis problems etc and it was because I carried all that extra weight around for over 20 years. But I can walk now without being out of breath, can enjoy my two granddaughters, just turned 50 yrs old. I do want to say after the honeymoon phrase is over, you have to work at losing the weight and keeping it off like anyone else and that's what I struggle with now. I continue to drink protein shake at least once a day. I let carbs slip back in and even with not gaining any of the 90 lbs back I wasn't losing any either. So about 2 years ago I decided to do the HMR diet to lose the last 40 lbs. I ate and drank their food and vitamins, lost only 28 lbs after 8 months on the program. I gave up eating peanut crackers and stuff like that, so it can be done. Long story short as soon as I started adding meats, veggies and fruit back in I gained all but 7 lbs of the 28 back in 2 months time. So here I am today with having low iron issues because I wasn't taking the vitamins made for us and trying to lose at least 20 lbs. For some good information go to these websites, obesityhelp.com and bariatriceating.com . I know I probably gave you more than you asked for but once you get me started, can't shut me up lol.