Question:
RNY or LAPBAND --210lbs???
Please don't tell me to lose the weight without surgery. Too many health issues--weight increasing. — Toby2 (posted on May 13, 2008)
May 13, 2008
I don't really understand your post. Most doctors are going to go by your
BMI in order to determine if you are eligible, and yeah, most of them are
going to require a few pounds lost prior to surgery. If you're not up for
that, then maybe this isn't for you. As far as which surgery, that's a
personal choice. Most doctors will give the pros and cons of each surgery
as they see and let you decide. Ask a lot of questions of your doctor and
get all the information you can. Good Luck!
— Shirley D.
May 13, 2008
I am for the RNY which I had. My dr. won't even do the lapband. I know
others don't agree but he said he has seen the band create problems because
it is a foreign object inside you. He has seen it erode in peoples stomach
and cause infections etc. Also if your are going to do it why do something
temporary. Just my opinion.... I am very happy with what I did. :)
— Claudia C.
May 13, 2008
Have you considered VSG - vertical sleeve gastrectomy?
— GlitterGal
May 13, 2008
I weighed 239 last January 8, 2008 and I had RNY. I don't regret it at
all. My insurance would not even cover lapband because of so many people
going back in and having RNY done afterwards. I have lost 61 pounds as of
May 13, 2008. On my way to the goal my doctor has set for me and am glad I
made the decision to have the surgery.
— ladonna08
May 13, 2008
HONESTLY,ITS UP YO YOUR DOCTOR. MOST WONT DO THE RNY UNLESS YOU ARE AT A
CERTAIN WEIGHT. i WAS TOLD THE BAND WAS PERFECT FOR SOMEONE WHO WANTED TO
LOOSE 60-100 LBS AND WAS DEVOTED TO FOLLOW UP. I HAD THE RNY BECAUSE I HAD
TO LOOSE 100-115 AND MY DIABETES WAS GETTING WORSE. IT KINDA SOUNDS LIKE
YOU REALLY NEED TO SPEAK TO YOUR SURGEON AND SEE WHT HE RECOMENDS. GOOD
LUCK.
— JACKIESMOM
May 13, 2008
First, evaluate how you became obese and which method will best help you to
address those issues (were you a grazer, a huge sweets eater or someone who
just ate big meals). Secondly, find out how much after-care you are
willing to adhere to. Third, find a surgeon with whom you feel comfortable
and utilize his experience, along with a trained counsellor to help you
undertand the pros and cons of each weight loss surgery method. Finally,
do not discount the many advantages of the DS.
— SteveColarossi
May 13, 2008
Well I had the Lapband 4/9/08 and I`m glad I did for I wanted to lose
grandually. I got the newiest band called the realized band. You should
talk to your dr. and get all the info about all the options you have out
there. There is several websites about the lapband if your interested.
www.lapbandtalk.com is awesome for all lapbanders that got the band and
www.realizeband.com
So good luck on what you deceide and remember you have to be the one
thats happy.
— moosey52
May 13, 2008
Go with your gut. There are risks and complications with both surgeries.
Research every little detail for both before you make your final decision.
I have fobi-pouch, gastric bypass, laproscopic 4 years ago, not a single
complication nor regret. Good luck. P.S. I didn't have to diet before
surgery. That depends on your test results, lipids, protein, etc.
— bariatricdivalatina
May 13, 2008
I don't usually answer these kind of questions...but because of your weight
and NOTHING else, if I were you, I would have the lapband if any surgery
because it is the least invasive...No other reason. I had RNY at 105 lbs
more than you weigh now...I was quite happy being 200 lbs and never would
have even considered WLS at that light weight...but that's just me. At 315
lbs...I wouldn't have even considered Lapband over dieting.
— .Anita R.
May 13, 2008
There are more than just 2 options available. Most people only hear about
the Lap Band or the RNY because that is all their insurance will cover.
Take this for what it's worth. I am telling you up front that I am NOT an
"Expert" on Weight Loss Surgery. I encourage EVERYONE to
RESEARCH EACH surgical option FOR THEMSELVES! THIS is the information that
I have found in MY research. I am giving it here in an effort to help
GUIDE folks and help them START their OWN journey into their OWN research.
There are a LOT of differences in the different types of surgical
procedures. There are a LOT of differences in different SURGEONS. Some
surgeons require more of their patients than others. Some PROCEDURES
require more of the patient than others. You need to do some research and
find the BEST fit for YOU. I just had a Vertical Sleeve Gastrectomy almost
3 months ago. My surgeon did NOT require me to lose weight. I had a BMI
of 43.6. Now that isn't NEARLY as bad as many people. Had I been HEAVIER,
he may HAVE required it. I don't know. What I CAN tell you is that I was
having problems with arthritis in my knees and my shoulder. That was three
months ago. Now it is almost GONE. There is just a TWINGE every now and
again but NOTHING NEAR the constant agony that I was in before! I was also
a Diabetic 3 months ago. I have had to DROP all of my diabetes medications
because the ONE glucovance pill that I was taking caused me to have my
blood sugar to DROP to 53 POINTS! My sugars are still a LITTLE high, but
under 150 and WITHOUT medication! In a FEW weeks with some MORE weight
loss, I figure that my diabetes will be in COMPLETE remission! I have lost
59 pounds since March 1, 2008 with my surgery (the Vertical Sleeve
Gastrectomy) and it was done WITHOUT feeling HUNGRY!
From what I have learned, your MAIN options are the Lap Band, the Vertical
Banded Gastroplasty, the Gastric Bypass, The Duodenal Switch and the
Vertical Sleeve Gastrectomy. There are other options, I am sure, but these
are the most common that I have found. There are also combinations of
these options ALSO available such as the Banded Duodenal Switch, the Banded
Gastric Bypass, and the Banded Sleeve Gastrectomy. The Banded options are
basically the same as the Regular surgeries but they have a Lap Band added
as additional insurance in case of future need.
The Lap Band: (http://www.obesityhelp.com/content/wlsurgery.html#LapBand)
is well known. It basically squeezes the stomach to make it smaller and
creates a pouch with a restriction at the top of the stomach which fills
quickly and empties slowly. The advantages of this surgery are that it is
reversible if needed and it is adjustable if needed. It is a HIGHLY
flexible procedure. This surgery is well known and excepted by many
insurance companies. It may be best for people who have a history of
cancer either themselves or in their family and may need to take
chemo-therapy and for women in childbearing years who may become pregnant.
There are also other reasons for wanting this type of surgery, but I don't
want to spend ALL day writing this. There is an effective Excess body
weight loss over 3 to 5 years of 50% to 60% noted in some studies. The
PROBLEM with this option is that there are sometimes complications with
this device. Some people have a reaction to the foreign object in their
body. People with immune issues should NOT have this device. Lupus and MS
patients for example, can have a reaction to the foreign body and it may
trigger an immune system response. Other issues with the Lap Band are that
it is common for the band to "Slip" on the stomach and cause the
pouch to enlarge thus causing the person with the device to eat more and
negating the purpose of the surgery. Some surgeons have started stitching
the band to the stomach to prevent this from happening. It would be wise
to ask your surgeon if you are considering this option if he does this.
Other times people have learned to "Eat around the Band" and
force the food PAST the band to fill up the rest of the stomach and thus
defeat the purpose of the band. Actually, this is an issue with ALL weight
loss surgeries. All can be defeated by a patient who is either ignorant or
intent on doing so. It seems to be MORE common with the Banded options,
however. Another issue with Banded options is that occasionally the bands
will erode the outside lining of the stomach causing damage to the stomach
that often needs repairs and calls for a removal of the band and or a
revision to some other type of weight loss option. This happens in about
less than 1% of the Lap Band Surgeries but it IS something that needs to be
taken into consideration.
In the Vertical Banded Gastroplasty:
(http://www.obesityhelp.com/content/wlsurgery.html#VBG) (commonly known as
stomach stapling) the surgeon makes a cut into the stomach to create a
pouch. He sews the pouch and places a band at the bottom of the pouch.
This banded option has less chance of the band slipping since the cut in
the stomach holds it into place. It also has the advantage of being
somewhat reversible but is not as easily reversible as the Lap Band. It is
NOT as well known as it's more famous banded cousin, the Lap Band. There
my be difficulties in getting this option with some insurance companies.
It has many of the advantages and disadvantages of the Lap Band surgery
with the exception that the Band does not tend to slip and let the pouch
expand.
The Gastric Bypass: (
http://www.obesityhelp.com/content/wlsurgery.html#RNY) is made when the
surgeon cuts the TOP of the stomach off and creates a pouch. An OLDER
version of this surgery left the stomach intact but had a line of staples
that was used to create the pouch. This method is no longer in use much if
at all. The surgeon then takes a length of intestine and BYPASSES it. He
takes the LOOSE end that is still attached to the intestines and sews it to
the SIDE of the pouch that was created from the TOP of the stomach. The
BYPASSED intestine is then attached to the side of the intestine that was
connected to the pouch so that BILE from the bile duct can empty bile from
the liver into the intestine. This option is often the DARLING of
insurance companies. Many companies that won't pay for any OTHER Weight
Loss Surgeries will pay for THIS one. THAT makes THIS surgery quite
popular for many surgeons! This surgery has the advantage of being a
HIGHLY effective tool in the arsenal of weapons against the foe obesity!
It has an effective rate of weight loss and maintenance of 60 to 80% in
some studies at 1 to 2 years. The DOWNSIDE of this weight loss option is
that there issues of malabsorption of minerals and vitamins due to the
bypassed intestine. This often leaves the patient reliant on his doctor
for the special supplements required to maintain his or her health. Other
issues are dumping, nausea, and vomiting. Dumping is basically when you
have diarrhea that is caused by the intestine's inability to absorb the
food that was eaten. Along with the diarrhea can come intestinal cramping,
sweating, palpitations and other unpleasant side effects. Some people
experience dumping with sweets. Others experience it with fats. Each
person seems to have their own issues but whatever they are, they cause
them to excrete the food that they ate before it was fully digested.
Nausea and vomiting, while experienced by many in ALL weight loss surgeries
is NOT experienced by ALL. It does seem to be MORE PREVALENT in the
GASTRIC BYPASS and DUODENAL SWITCH patients according to the research that
I have seen. The gas and foul smelling stool are also a result of the
shortened digestive process due to the bypassed intestine in both the
Gastric Bypass and the Duodenal Switch.
The Duodenal Switch: (http://www.obesityhelp.com/content/wlsurgery.html#DS
) is the STRONGEST tool in this arsenal of weapons! Many surgeons think it
shouldn't be used lightly and often only recommend the procedure for people
with a body mass index OVER 50! In the Duodenal Switch, the surgeon
REMOVES approximately 85% of the stomach including MOST of the region of
the stomach that produces the hormone grehlin. Grehlin is one of the
hormones that create HUNGER. Removing the section of the stomach that
creates hunger is a HUGE feature of this procedure. The surgeons then sew
the rest of the stomach back together and create a tube shaped stomach that
resists stretching. The stomach varies in size depending on the surgeon
and the patient but can be anywhere from 2 ounces to 6 ounces. Perhaps
more. The next step of this procedure involves bypassing the intestine
just like in the Gastric Bypass. Instead of attaching the intestine to the
SIDE of the stomach, it is attached to the BOTTOM of the stomach where the
intestine used to exit. The bypassed intestine is then sewn at one end
near the liver and the far end of the intestine is sewn to the intestine
that was attached to the stomach to pass bile to the intestines as it does
in the gastric bypass. This procedure is MORE efficient than the Gastric
Bypass in losing weight. This option has an effective rate of weight loss
and maintenance of 70 to 90% in those same studies. The downside when
compared to the Gastric Bypass is that Insurance companies often do not
know of this option and are often reluctant to pay for it. This option has
many of the same issues as the Gastric Bypass. There are some severe
malabsorption issues. There are often issues with dumping, nausea,
vomiting, GERD (acid reflux), gas and foul smelling stools. The Many
surgeons have been reluctant to perform this surgery due to the severity of
the complications that can arise. This is why it is often reserved for
those who are considered severely morbidly obese. Many surgeons had looked
for an alternative to this surgery which lead to what was initially
considered a "Half Duodenal Switch" or as it later became known,
the "Vertical Sleeve Gastrectomy."
The Vertical Sleeve Gastrectomy:
(http://www.obesityhelp.com/content/wlsurgery.html#VSG) (if you get the
same picture as the Vertical Banded Gastroplasty, just scroll UP) is a
GREAT tool to use in the fight against obesity. While not QUITE as
effective as the Duodenal Switch, it is often JUST as effective as the
Gastric Bypass without the severity of the side effects of EITHER of those
two options. The Vertical Sleeve Gastrectomy initially started as an
attempt to create a safer Duodenal Switch alternative. While early
attempts were not as successful in weight loss reduction, this was mainly
due to the fact that the surgeons were relying on the larger size stomach
often used for the Duodenal Switch patients who often rely on the
"Switch" part of the surgery for some of the weight loss. Once
the surgeons started reducing the size of the STOMACH, the Vertical Sleeve
Gastrectomy became a much more effective tool at helping the patient loose
weight. In the Vertical Sleeve Gastrectomy, the stomach is cut and
approximately 85% of it is removed. Just like the Duodenal Switch, most of
the cells that produce the hormone grehlin are removed. This eliminates
most of the hunger that the patient used to have, if not all of it. The
stomach that is made from what is left is turned into a tube that is
resistant to stretching. This tube is often designed to hold from 2 to 4
ounces of food or liquid. At this point the surgery is complete. The
surgeons just need to close up and the patient needs to recover. The
upside to this surgery is that it is simple and has one of the LOWEST rates
of complications of all the weight loss surgeries. It also has one of the
HIGHEST rates of excess weight loss with one study in California coming in
starting at 58% to 77.9% loss in a ONE to TWO year study and one doctor in
England reporting that 100% of his patients had a weight loss and
maintenance OVER 70% at 6 YEARS of living with the Sleeve. He also
reported that patients with hypertension, diabetes, impaired glucose
tolerance, obstructive sleep apnea, asthma, or arthritis were all cured or
improved after surgery. It has also been said that this is the ONLY
recommended option for people with immune system problems. People with
diseases like Lupus or MS can have this procedure because there is NO
foreign object placed in their body. This also is one of the few
recommended options for people with organ transplants. People with
transplants need their intestines to metabolize their anti rejection
medications. There are possible issues with GERD in this surgery as there
are with the Duodenal Switch There are NO malabsorption issues with this
surgery. There are NO additional foul odors. There is NO additional
intestinal gas. While nausea and vomiting is common in ALL weight loss
surgeries, it is NO MORE PREVALENT in the Vertical Sleeve Gastrectomy than
in most of the other options. If needed, the Vertical Sleeve Gastrectomy
can be easily converted to a Duodenal Switch should additional Weight Loss
measures need to be taken at a later date. This act is called a
"Revision." Having your Vertical Sleeve Gastrectomy converted to
a Duodenal Switch would be said to be having a, "Revision of your
Vertical Sleeve Gastrectomy to a Duodenal Switch."
The Biggest DOWNSIDE to the Vertical Sleeve Gastrectomy is that it is
considered "Experimental" by many insurance companies. While it
has not been practiced HERE in the US as a weight loss option for very long
(about 5 years or so) it has been done for QUITE a while in Central and
South America and in Europe for quite some time. The surgery has been used
HERE in the US for OTHER reasons for QUITE a while. It has been used QUITE
effectively to treat stomach cancers and ulcers with good effect. These
treatments have been done in the US for quite some time.
Options for getting surgeries that are not paid for by insurance can be
found if you are persistent. You can sometimes petition the company and
get them to reconsider with a doctor's explanation. You can also self pay
or take out a loan. Many times, the surgeries are cheaper in Mexico or
other central or South American countries. Do some research to find your
options.
Not every surgery is going to be right for every person. Frankly, for ME,
if I were an obese male with a BMI under 50 (which I am) or an obese woman
NOT of child bearing age, I would choose the Vertical Sleeve Gastrectomy
(which I DID). If I were an obese male with a BMI OVER 50, I would get the
Duodenal Switch. If my insurance company would not COVER it, I would get
the Sleeve. If not THAT, then the Gastric Bypass. I would keep working my
way down the list until I found SOMETHING that I could get. If the
insurance company wouldn't pay, I would try to take out a LOAN (this is
actually what my wife did for me). If I were a WOMAN of child bearing
years or a person facing the possibility of chemotherapy or some other
health issues that would require periods when I would NEED more sustenance,
I would want the flexibility of the Lap Band. The short of it is, Do YOUR
RESEARCH and CHOOSE the right surgical option for YOU! If you can't get
ONE option for a reason, at least get another! For the sake of yourself
and the ones you love, do SOMETHING to fix the problem before it is too
late. If you die due to health problems caused by obesity, it is TOO
LATE!
Whatever surgical option you choose, for whatever REASON you choose, we are
ALL here for the same reason. We are here to HELP and BE HELPED. Please,
let's respect each other.
For an updated version of this message look at my profile page at:
http://www.obesityhelp.com/member/hubarlow/ . Look for an article named
Surgical Comparisons in my blog. If you cant find it on the main page,
look in the March Archives. The updated article will have links to some
video clips that show the various surgeries being done and have surgeons
explaining the pros and cons of each type of surgery. Use these as the
basis to start your own research so that you can make your own INFORMED
choice about what type of weight loss surgery you feel is best for you.
Should you find that your insurance will not PAY for the type of surgery
that you think is best and you cannot AFFORD to pay for it YOURSELF, then
get the BEST surgery that the INSURANCE will pay for or find a way to MAKE
them pay for the surgery that YOU WANT or NEED. It CAN BE DONE. Often all
it needs is that there be some kind of medical NEED for you to have THAT
SPECIFIC SURGERY and for your DOCTOR or SURGEON to sign a form STATING
THAT. Get whatever advice and help you can and go for it.
I hope this helps
Hugh.
— hubarlow
May 13, 2008
Nevella, if you really struggle with gain, then I would suggest rny, it's
more permanant and less chance of cheating during the process, but I will
be honest with you, you can cheat yourself out of losing weight with either
surgery, you have to be ready to grow up about eating habits and change
your life, or surgery is a waste of time. Harsh words I know, but said in
love, I promise. Patricia P.
— Patricia P
May 13, 2008
At 5'4" and 303lbs I chose lap band. I am a bulk eater. The band
causes enough rstriction to giv me a "full" signal early so I eat
much less, but am satisfied with that. A sweet eater usually does better
with gastric d/t the potential of dumping. But in reality, you nd to do the
research, learn how each surgery works and decide for yourself. Donna, RN
— Donna O.
May 14, 2008
I am not sure of your health issues, as you did not state them, but if one
of them is Diabities Type Two then look at a RNY, as they day you leave the
hospital, you moist likly can toss the pills or insinlin you have been
taking. I did after having Type II for 25 years. Talk to a good surgeon,
got to a seminar, and look at all the facts. I love the RNY, but you need
to know what changes you will be comitting to in your life in excahange for
the weight loss and resolution to health issue. I would do it all over
again the same way, but you have to be comitted. Excersize is part of most
programs. I was not sure about doing it, but I do it every day and love it
now that I am not hauling around a ton of fat.
Best of success to you.
Bill
— William (Bill) wmil
May 14, 2008
I am TOTALLY where you are - some people might scoff at your weight but at
205 (now 197) I am going to Mexico to get my LapBand next week! You are
well within the limits to qualify. It's less than $8,000. I have done 60+
hours of research and read thousands of blogs; read several books too -
this surgery IS for me. Good luck and you don't have to explain yourself
to anyone - go for it! [email protected] jen Wilkin
— wilkin
May 14, 2008
lapband
— Kimberly F.
May 15, 2008
Don't limit yourself to just those 2 options. Check out VSG-Vertical Sleeve
Gastrectomy as well. It is working great for me. No malabsorption issues
and no long term maintenance.
— corky1057
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