Lap band isn't a good idea?!

Jenn C.
on 5/10/12 4:21 pm - Naugatuck, CT
RNY on 10/21/13
Can someone clarify to me why the Lap Band would be a poor choice with someone that has Type 2 diabetes? I posted somewhere else on the forums and I got a response that stated that I am better off with the RNY/DS. 

I have personal reasons why I am steering clear from the "Gastric Bypass" but if it's the ONLY thing I can do then,...well then I'll get it. I prefer the Lap Band though because to me I feel it is less invasive AND it's reversable. I haven't done too much research yet, as I have recently made the decision that I would like it/need WLS. Anyways, this person stated that "If I weighed less", then thats a different story. Might I add I am 6ft tall and my last weigh in during March was 356lbs. I have since been dieting so I might be a good 10lbs lighter. Oh and I'm a lady  

I did a quick web search to back this person's response and I found NOTHING that says diabetics should not do the Lap Band, if anything I found some info that said the Lap Band "cured" a lot of patients with diabetes or tremendously helped control it.

Ugh!!!!! 
funkyphillygirl
on 5/11/12 12:36 am
Here's my two cents on it - and I will first say that I am 25 years a diabetic (type 1.5 - insulin dependent and insulin resistant) and had RNY in September 2011.  I researched this a LOT - 9 years in fact, so here's what I know from that process:

The RNY sugery not only changes the size of your stomach, but there is also surgery to the upper part of your intestines - that the bypass part.  As you may know, the surgery is both restrictive (reducing the size of the stomach) and malabsorptive (changing the way that your body digests and uses food).  That is where the "magic" happens for diabetics and where the potential is to normalize blood sugar.  I cannot describe what that action is, nor can most doctors (not in layman's terms anyway).  But, the enzymes and hormones that are at work in that part of your body have a very positive reaction to the surgery and really work toward normalizing blood sugar.  So, although you are certainly eating fewer calories, the body is now processing what you've eaten in a different way.  And, again- that's where the good things happen for diabetics.

Since the band is ONLY restrictive (NOT malabsorptive), your stomach size is reduced so you eat less.  But your body still processes everything the same.  So, you don't get that "magic" as a diabetic.  And that is why there is some question about whether the band really is effective for diabetics.

In my case, I never considered the band for that reason.  I considered both RNY and duodenal switch surgery.  DS is also considered very effective for diabetics for very similar reasons, but the surgery action is MORE malabsorptive than RNY.  I already have osteopenia (a step before osteoporosis) and had already had a spinal fracture because of it, so I deemed the risk too great for DS.  Calcium is one of the minerals that the body has some difficulty retaining after either surgery, so you have to up your calcium a lot after either.  But DS is slightly worse.

I was not an overeater before the surgery and carefully watched my calories and carbs because of being a long-term diabetic.  But I gained almost 100 pounds after I went on insulin.  Now, 8 months after the surgery, I've lost 70 of those pounds, and only eat about 200 calories less than I did before the surgery.  But, now my body can actually metabolize and I lose weight.  It's all because of the surgery that occurred to my digestive track.  And that DOES NOT HAPPEN with the band.

Of course, you need to talk to a surgeon and get more information about what options are best for you.  I saw 3 different surgeons before choosing the one who did my surgery.  As I mentioned, I researched for 9 years.  I've done very well and could not be happier.  I do still use insulin, but that is because I am more of a type 1 diabetic.  However, I use MUCH less of other diabetic medications (eliminating 2 orals, 1 injectable), less overall insulin now, and half of one of my orals.  I've eliminated cholesterol medication and recently went back to my blood pressure med on about half the dose.  So, the effects have been very positive.

Does this help at ALL?  It's a big decision, so you owe it to yourself to research, ask questions and fully understand what you options are.  That is how you will make the best decision for you. 

Please post again with any additional questions or thoughts, OK?

Best of luck!
Jenn C.
on 5/11/12 2:54 pm - Naugatuck, CT
RNY on 10/21/13
 I really appreciate your response! I'm actually having second thoughts about the lap band. I think most of my indecisiveness is out of pure fear and not knowing, ya know? 

I have so many people telling me to just do the RNY and completely forget about the lap band bascially for the same reasons you posted. They are VALID reasons though. At the end of the day, my health is most important and I can't deal with all this excess weight any more. I've done every diet and i'm only getting sicker. Not only do I have the T2, but I also have an enlarged liver which obviously will cause me HUGE issues if I continue to be obese. I think i'd rather do an RNY rather than have a liver transplant! [insert sarcasm] My dad had one, believe me, his life is NOT the same- I don't want that for myself! 

The reason why I wanted to avoid the RNY is because of my mom. She had hers in 04' and granted, she has successfully lost all of her weight except for some weight gain due to steroids.
I watched the pain she went thru, the awful vomiting/ dumping BUT I also watched her transform within WEEKS, next thing I knew it, my mom was stealing my clothes
I think my mom doesn't want me to get it because it's premanent. I don't know...but I have other health issues I need to address.

I really, really appreciate your nonbiased opinion. I will definitely look into the RNY!
funkyphillygirl
on 5/11/12 3:30 pm
Well, I DO have a biased opinion because I also had RNY...but I did research heavily so that I made the right choice for me based on what I learned.

You mentioned that your mom had a difficult time post-surgically.  I am so sorry to hear that. Was her surgery open or laparoscope?  I am betting that, since it was 2004, it was open.  Things have really changed since she had her surgery.  Many surgeries are now laparoscopic - less pain, less chance for complication, quicker healing - all very positive changes.   I have to say that I breezed without much trouble at ALL and mine was a laparoscope.  That should be part of what you explore with a potential surgeon - how does he/she do these surgeries?  is there any reason why you cannot have yours done that way?  these are all great questions for a surgeon and his team.  They will lay all of this out for you and talk with you about what is best for YOU.

I was in the hospital for 3 full days and discharged on the morning of the 4th day.  I was kept an extra day for blood sugar control issues.  I did not even need any pain medication at ALL after the first full day, even though it was readily offered to me.  I just didn't need it.  I came home with a prescription for pain medication than I never even had to fill.  Liquid Tylenol was all I needed.

Even the nausea was very, very limited and I had none in the 4-6 weeks after surgery.  After I started on solid food, I had 2 very small episodes of vomiting.  But, basically I took a bite of something that didn't sit right and it just came right out.  No drama, no dry heaves, no ongoing issues - nothing.  It went in - and it came out.  Done.  And I instantly felt fine.

I also have not had any dumping at all in 8 months.  My stomach makes some interesting noises sometimes, but I have not suffered any of the classic dumping issues.  Not once.

I was prepared for all of these issues, but that's why I said I breezed.  I followed directions to the letter, walked a ton, and was really in good shape very quickly.  The morning of my discharge, the residents came in at 6 a.m. and I blasted the with "I Feel Good" off my iPod - because I DID feel good. 

Again, I hope you don't mind me addressing these things so directly.  I am not telling you what to do, but rather sharing my experience with you.  But, as a diabetic, I do think the malabsorptive aspects of RNY or DS will make a big difference in T2.  And all of that can only have a positive effect on your other medical issues as well.  Talk to a surgeon - heck, talk to two surgeons. Go to info sessions, ask questions, read, check out this site - you'll get your brain wrapped around the significant issues for you and then you will come to know what is best for you.  Look how much you've benefitted by just posting in here, right?!
Jenn C.
on 5/11/12 7:36 pm - Naugatuck, CT
RNY on 10/21/13
On May 11, 2012 at 10:30 PM Pacific Time, funkyphillygirl wrote:
Well, I DO have a biased opinion because I also had RNY...but I did research heavily so that I made the right choice for me based on what I learned.

You mentioned that your mom had a difficult time post-surgically.  I am so sorry to hear that. Was her surgery open or laparoscope?  I am betting that, since it was 2004, it was open.  Things have really changed since she had her surgery.  Many surgeries are now laparoscopic - less pain, less chance for complication, quicker healing - all very positive changes.   I have to say that I breezed without much trouble at ALL and mine was a laparoscope.  That should be part of what you explore with a potential surgeon - how does he/she do these surgeries?  is there any reason why you cannot have yours done that way?  these are all great questions for a surgeon and his team.  They will lay all of this out for you and talk with you about what is best for YOU.

I was in the hospital for 3 full days and discharged on the morning of the 4th day.  I was kept an extra day for blood sugar control issues.  I did not even need any pain medication at ALL after the first full day, even though it was readily offered to me.  I just didn't need it.  I came home with a prescription for pain medication than I never even had to fill.  Liquid Tylenol was all I needed.

Even the nausea was very, very limited and I had none in the 4-6 weeks after surgery.  After I started on solid food, I had 2 very small episodes of vomiting.  But, basically I took a bite of something that didn't sit right and it just came right out.  No drama, no dry heaves, no ongoing issues - nothing.  It went in - and it came out.  Done.  And I instantly felt fine.

I also have not had any dumping at all in 8 months.  My stomach makes some interesting noises sometimes, but I have not suffered any of the classic dumping issues.  Not once.

I was prepared for all of these issues, but that's why I said I breezed.  I followed directions to the letter, walked a ton, and was really in good shape very quickly.  The morning of my discharge, the residents came in at 6 a.m. and I blasted the with "I Feel Good" off my iPod - because I DID feel good. 

Again, I hope you don't mind me addressing these things so directly.  I am not telling you what to do, but rather sharing my experience with you.  But, as a diabetic, I do think the malabsorptive aspects of RNY or DS will make a big difference in T2.  And all of that can only have a positive effect on your other medical issues as well.  Talk to a surgeon - heck, talk to two surgeons. Go to info sessions, ask questions, read, check out this site - you'll get your brain wrapped around the significant issues for you and then you will come to know what is best for you.  Look how much you've benefitted by just posting in here, right?!
 Haha OOPS ur right about being biased....gotta LOVE 3rd shift tiredness! I definitely want to hear experiences and yes, it was open. My poor mom has this huge zipper scar-her bypass and her hysterectomy. It's horrible! On the other hand my boss had the laproscopic route and she's got 5 tiny little lines, that the only reason why I was able to point them out is because i've seen enough pictures of scars from other people. 

I have to ask and excuse me if I don't make sense...it's 5:30am and I want my bed lol but did you have any gross farting issues??? I keep reading that people have serious bowel issues, I've even read that a few people know what days of the week they're gonna poop. Is that a normal thing? Do you not go like you are normally supposed to? I mean, it kind of makes sense being rearranged.


funkyphillygirl
on 5/12/12 3:19 am
I have not had any of that.  I do battle constipation a bit now, and go just about every other day.  I've learned by reading some of the RNY boards how to manage it though and have talked to my doctor about it.  (It's super common....)  I usually take 1-2 stool softeners about every day and also have added some fiber chews.  That stuff and staying hydrated and exercising really does make a big difference.  It's annoying, but certainly not life altering, if you know what I mean....definitely manageable.

I do find that I belch a bit more now, but nothing terrible.  It seems to happen when I drink fluids a bit more.  I guess air and liquid get in there and need to find their way out.  But definitely not gross or smelly farts or anything like that.  None.

Another hesitation I had about DS was exactly the gas issue. There is someone else I know who had it and that issue is the talk of his staff.....I couldn't fathom it.  I know him and know that he also eats a lot of sugar, carbonated bevs, etc. and that can't be helping that problem.  But I was mortified at the thought that my digestive issues might be the talk of my office, so that was another thing I was concerned about (like you). 

Keep the questions coming.....I wish I had had someone answer some of these things for me in the decision making process!  And get some sleep.....
(deactivated member)
on 6/7/12 9:07 pm - United Kingdom
If you are in the UK you can call for a free consultation with a bariatric surgery expert about this issue and more http://www.thebariatricgroup.co.uk/non-surgical/one-to-one-process/
You can also find out about all the post operative care.
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