Lap-band and ~60 BMI?

I was banded 12/17 and am doing fine through the post-op plan my doctor gave me.  I'm wondering if there are other bandsters here with high BMIs?  I know most people with this much to lose get RNY or DS, but I am self-pay and have concerns about malabsorptive procedures long-term.  Alyson, starting at 348 (BMI ~60 depending on how tall I stand ;-) )

Alyson, If I am guessing correctly, you need to lose about 200 pounds.  And the band (and RnY) will ON AVERAGE get you to about 228 and a BMI of 39.1...which probably sound pretty good from where you stand but, with comorbidities, you'd STILL be considered eligible for weight loss surgery. AND..if you are self-pay...(I'm a formerly banded, now revised to DS person) you will have to pay for all adjustments (aka fills) out of pocket...or at least those beyond what your surgeon offers as part of his program.  Depending on where you live, an adjustment could cost from about $100 (Tijuana) to $1100 (Cedars-Sinai, near Beverly Hills.) Some people NEVER need an adjustment.  Some need several.  One person I know needs one every time she gets on an airplane.  She ends up in ER's giving instructions to ER docs who have never seen a band.  For her, this is not a big deal and she loves her band.  For me it would be a deal breaker. If you are self-pay for the band placement, you would also be self-pay if it had to be removed, right?  Are you prepared for that? (My band is gone because it caused esophageal damage and then I lived off of mostly-liquids for about a year and a half and regained everything.)  I don't post head-shots.  But the photo  on the left is me, three years after banding and just before I had a revision to DS.  On the right I'm about a year and a half post-DS.  I've lost a few more pounds since then.  I'm not an RnY fan, although I have happy camper friends who are.  I prefer the DS-related malabsorption and a more normal diet.  With EITHER malabsorptive procedure, you need to worry about supplements FOR THE REST OF YOUR LIFE. Also, consider the sleeve.  With it, you might lose a good deal of weight without malabsorption and--if your current weight has anything to do with why you are in a self-pay situation--you may be in a better position to acquire insurance that would cover a revision to DS (the DS is the sleeve + the malabsorptive part) if that is needed. Good luck working it out and c'mon over to the DS board and ask there about the malabsorption.  I'm older so I don't have to worry about nourishing a fetus or anything,,,but we have young folks there who have done fine with that sort of thing. Sue http://www.obesityhelp.com/forums/DS/a,messageboard/board_id,5357/

Sue - Yes, to reach a "normal" BMI I would have to lose just over 200 lb.  BUT to get knee replacement surgery I need to be at or below 225, so average results will enable me to become more active regardless.   Yeah, low 200's sounds pretty good right now, since I haven't been there since I was in my mid-20s! As a self-pay client, with my surgeon I do not have to pay for fluoroscope fills or complications, including removal if necessary. I have insurance through my husband's employer but the industry group to which they belong did not purchase the rider covering treatment of obesity.  ANY treatment .  It is possible a future employer will cover obesity treatment, including surgery, though any future employment will probably be with a company in the same industry group, so I may have to wait until employer-based insurance is phased out for something more inclusive, or as you say, until I'm able to buy more affordable individual insurance.  Right now I'm not thinking about a possible second surgery, just hoping to work this process the best I can, making permanent changes in eating habits and reducing my joint pain so I can be a more active mother with my children.  I was pretty damn active in the low 200's - hiking, cross-country skiing, etc..  With bionic (lol) knees I might be able to maintain a higher activity level again, increasing my chances of being on the low side of the lap-band average. Thanks for the info about DS - I've read about all the options thoroughly and am sure that this is the right decision for me at this point in my life.   I just wondered if there were any others around :-)  I'm glad there are so many options for people to reach their goals! Thanks for the response - Alyson

Alyson,

Wow I had my first knee surgery 2000, at 450 lbs and my second on the other leg 2004 at 465 lbs and did ok with both.

Pam - Wow, that's interesting!  The two orthopedists I've consulted with said they wouldn't do knee replacement until I was <225, and they didn't know anyone who would...  Something about the extra wear and tear of the weight on the replacements causing them (or the surrounding bones) to wear out sooner, and the decreased success rate of subsequent replacements at my age (I'm in my early 40s). But I needed to lose the weight anyway, so I guess this is a good path.  Who knows, maybe when I get to that point I'll be able to stave off replacements for another couple years?  Thanks for sharing your experience.  Wow, you're making a lot of progress - congrats! Alyson

I don't know of anyone who is a regular on this board who's been banded.  In my case, my surgeon refuses to band anyone with a BMI over 60 because the amount one would lose on average would still leave you obese.  However, he will refer patients to other surgeons if that is what they want.  I can understand your decision, and of course an average is just that, it includes the best and worst performers.  If you are very determined you will be among the best performers :) I wish you the best and hope you join us on this very nice, very supportive message board.  Some of us post our exercise daily, which is a nice way to stay accountable and feel proud as your fitness improves.  Some of us also post our weight loss weekly in the Monday weigh-in.  Feel free to join in!  Happy New Years and congratulations on making the choice to lose weight! Jenn

Thanks, Jenn.  If I stand my straightest my BMI is just under 60 and even at my slumpiest height two weeks of pre-op Medifast brought me below 60, but I totally get why a surgeon would set a cutoff. Thanks for you well wishes - I hope I'm one of the best performers, too.  I know I have a lot of motivation!  My turning point for going forward with the surgery was a conversation with my 8-y.o. son about our trip to Hawaii two years ago.  I realized that despite my size, two years ago I was jumping in the surf with my son, and this year, due to increasingly deteriorating knee and hip joints, I'm not sure I could even walk on the sand :-( Posting exercise and weight loss for accountability is a great idea.  I'm not cleared for exercise yet, and I get my first weigh-in on Thursday.  I'm looking forward to seeing how much I've lost so far!  I know that my 300lb scale was oscillating wildly in the 325-365 range before surgery and is now hovering less frenetically around 315, so with a doctor's starting weight of 348 I'm hopeful I've lost quite a bit in the last month.  Maybe next month I'll actually stop torturing the scale by being in it's accurate range, lol! Happy New Year to you, too! Alyson

Alyson, I apologize.  I skipped right over the part that said you are already banded.  In that case, ride that pony and see where it takes you! good luck, Sue

No problem, Sue - thanks for the response :-)