lap band complications?

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  • lilmissy2
    lilmissy2 Posts: 595 Member
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    i'mm amazed that i keep hearing stories about gastric bypass recipients gaining all their weight back. i honestly thought the surgery made that virtually impossible because of the reduced stomach size, malabsorption, and dumping syndrome. how do these people manage to consume enough calories to gain their weight back?

    Actually, theoretically a gastric bypass patient could eventually return to normal eating and normal absorption... the body has crazy adaptive processes sometimes. I mostly see bypass patients who have had the surgery for reasons other than weight loss (ie cancer) and they usually adapt reasonably well. The malabsorption can be hideous and patients often become very malnourished very quickly. You do have to remember though, that for obese people having a bypass, there is an extra risk simply from rapid weight loss. Dumping syndrome is not what you are thinking (from how you have described it in other posts)... and it's not usually a long term thing but it is very nasty and very dangerous because it can result in very fasts drops in blood pressure and blood sugar. I personally do not think gastric bypass should be offered as an obesity treatment but I do think lap banding is appropriate for some people although not as a first-line management option (ie they should be offered appropriate lifestyle counselling first and if this fails, ie they do not lose adequate weight or they regain lost weight then it should be considered).
  • jasonweinberg
    jasonweinberg Posts: 270
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    lilmissy2 i have spent quite a bit of time learning directly from the dr.s at the program i am in so let me clarify what i am referring to as dumping syndrome. this is pretty much verbatim what they have taught us: because of the introduction of a previously lower section of the intestine directly to the now smaller stomach (which also doesn't digest food as fully) foods high in either (or both) sugar and fat will cause the eater to feel nauseous and often vomit. this is basically supposed to act as a behavior modification to force people to avoid high sugar and high fat foods. my dr. pitched that to me as a major advantage to the bypass and why results are so much more consistent with the bypass.

    i do know that the stomach can stretch back out over time. i suppose once it does, the no longer newly introduced intestine could lose its sensitivity to sweet and fatty foods, allowing the eater to return to bad habits. i just didn't realize it could be dramatic enough to allow them to gain back all of the weight they lost. my understanding is that with the lap band they can continue to adjust the restriction if needed down the line.

    i tend to disagree about not offering the lap band unless lifestyle modification fails, because the lap band really won't work without lifestyle modification anyway. you can still eat junk if you so desire, only in smaller portions.
  • lilmissy2
    lilmissy2 Posts: 595 Member
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    Only early dumping syndrome has anything to do with vomiting or bowel symptoms and to be honest, most gastric bypass patients I have seen experience late dumping. Late dumping syndrome refers to altered hormone responses induced by rapid intestinal transit that cause fast drops in blood glucose and blood pressure especially if the person stands up not long after eating. I think people (Drs included) get side tracked by the name of dumping syndrome, just because you have vomiting and diarrhoea does not mean you are have it and not having those symptoms certainly doesn't mean you don't have it. It is a very complicated condition to diagnose. Also, while sugar intake is reduced in treatment, fat intake is generally increased.

    http://www.healthsystem.virginia.edu/internet/digestive-health/nutritionarticles/uklejaarticle.pdf
  • lilmissy2
    lilmissy2 Posts: 595 Member
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    i tend to disagree about not offering the lap band unless lifestyle modification fails, because the lap band really won't work without lifestyle modification anyway. you can still eat junk if you so desire, only in smaller portions.

    My point wasn't that I think people are pathetic and want to see them make the lifestyle change. Every surgery has risk and I don't think patients should be put at risk when they haven't exhausted other options (I didn't take an oath like Drs but I still believe in do no harm!). Also, when I said 'failed at lifestyle modification', I didn't mean ate loads of junk food when they should have been eating healthily. There are actually a good proportion of people out there who struggle to lose weight even when they restrict calories successfully... especially if they have lost and regained weight in the past. That is what I would call failure of lifestyle modification.
  • jasonweinberg
    jasonweinberg Posts: 270
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    you already referred to the fact that most of the bypass parients you are familiar with did not have it as a weight-loss surgery. supposedly, early dumping, which generally does cause the vomiting tends to be caused by fatty foods and late dumping, which as you described and can be more serious, is caused by high carbs. that's why, for example, the person earlier in this thread described someone vomiting after eating french fries. i am sure many times when people who have had the bypass as weightloss surgery make bad choices they are actually eating foods high in both fats and carbs.
  • jasonweinberg
    jasonweinberg Posts: 270
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    i understand what you are saying about weight loss surgery as a last resort, i just don't really agree. if i did, i obviously wouldn't be having a weight-loss surgery. i don't really know where the term "pathetic" came out of what you read from my post. lots of people eat lots of junk. i have made lots of bad food choices over the years that have helped lead to my morbid obesity. if i continue to make those bad choices after my surgery they will continue to punish me. it only works if you work with it.. for many years, i have been treated with high blood pressure medications and a cpap machine. high blood pressure medicines have side effects, including slowing your metabolism and contributing to potential weight gain. but you have to treat high blood pressure or it wreaks havoc on your body. i also lost down to my ideal weight previously in my life and managed to gain it all back. a wls is going to hopefully help me avoid that, and help me to stay off or at a lower blood pressure dose and maybe even allow me to sleep without a breathing machine. i was also tracking towards diabetes and can hopefully avoid that as well. i can also lead a more active life, which will have all kinds of health benefits. to me, the risks of potential negative side effects are far out-weighed by the potential benefits. my doctor and my insurance obviously agree, or they wouldn't be recommending and paying for it.
  • sbased
    sbased Posts: 14
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    Hi! First of all congratulations and good luck you have my support. I am also considering lap band surgery after being on weight watchers for two years and losing 35 lbs the hard and I mean hard way. I have exercised, restricted, gone to behavior modification and over eaters anonymous. I have asked for the surgery for me and am reading up and doing research like you. I put in my initial paper work and hope to hear something positive.
    In the meantime, I have not heard of too many problems with people other than obstructions and dumping. I want to feel what someone's stomach is like after the surgery - do they always have a bump or port feeling? Also I want to continue losing at a slow pace (which I have done more than slow over the past two years) so that it is natural so lap band seems perfect to me.
    I think its all about how you feel its a personal choice. I've asked my therapist - who is great by the way - and while she does not think that its the best decision she supports me and we will continue to keep working on this together.
    I also get told "you don't need it", "its a cop out", etc. well struggling with this weight, counting every calorie and working through my issues is not a cop out and i think lap band is just another tool like therapy, healthy eating and exercising. Good luck again!
  • SarahElittlebit
    SarahElittlebit Posts: 66 Member
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    Hi. I'm new on this site, but wanted to give it a try. I had the lap band surgery a year ago. It took 3 months to get it filled to where it was working successfully. After that I lost over 60 pounds in the next 6 months. Then, I had a set back and regained all of it. I injured my hip falling on the ice, so I couldn't work out and had a lot of stress happen all at once: death of a brother, fighting in the family, worries about keeping my job due to budget cuts, and medical conditions. I have a hypo thyroid which makes losing weight a challenge. This too was off the limit this spring and I was getting too tired all the time and starting to get depressed. I also had a breast cancer scare, which thankfully just turned out to be a cyst.

    Last month I finally made an appointment with the Bariatric Surgeon, who is awesome by the way. He added some fluid to the band which was too lose. I hadn't seen him in a year as I felt guilty. Now I have 6.5 cc's of Saline in the band and it is working beautifully again. I had my Thyroid checked and the dose readjusted. I've lost 15 pounds since then and am back on track. I have more energy and am looking forward to each day.

    My suggestion to anyone thinking about having this surgery is to make sure it is right for you. Can you stick to the restrictions? Will you commit to keeping in touch with the doctor whether things are going well or not? It is a slower, but healthier alternative to the Rouh-N-Y procedure but takes more dedication and determination to see it succeed as there isn't the dumping that occurs with that process.

    I have run into others with severe complications that have had them worked out in the end, but haven't seen many myself. Most of the problems I've seen, other than what I listed was in regards to what I eat. I find I can't eat anything too dry as it won't go down. I have to be careful about who I eat with. If I eat with people that I get in a heated discussion with at the table, I forget to chew properly. When I get blocked, I find my chest hurts. I usually drink water to loosen it and throw up what ever I ate in order to clear the block and prevent further problems. I don't go back to eating. I wait until I am hungry again and then I have a small snack.
  • jasonweinberg
    jasonweinberg Posts: 270
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    had my surgery and everything went smoothly...

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