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?!

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!

Well, this is where I would start being proactive by questioning....and working with the insurance approval folks at the surgeon's office for any ideas or things they can do to help you be your own advocate.

Those other medical issues are equally valid - why would they wait until you ALSO have full blown diabetes, which will add additional expense to your ongoing medical care?  I am sure the surgeon's office has worked with this insurance before - maybe they have some tips for you about how this can be positioned to your advantage?  Maybe a letter from you or them would be persuasive?  I was assigned a nurse case manager at my insurance company, who used to call and bother me all the time.  I really didn't need the service, and politely thanked them....but perhaps one can be assigned to you that can help you navigate the system.

Basically, I would start appealing this decision through any venue available to me and making enough noise, while politely but firmly pointing out the illogical standards here, that they would just want me to go away (and thus approve the surgery).

This may be a new or unfamiliar way of doing things for you, so I understand if these suggestions make you cringe a bit.  But advocating for yourself can be very powerful and persuasive and is maybe worth a try?

Congrats on your decision to take control of your health.  It's so important.

I'm a little confused as to why your BMI does not already qualify you for surgery?  Did a bariatric surgeon tell you that you needed to be "diabetic" or was that your family doctor?  If not a surgeon, I'd try to get to one to find out what else might qualify you for surgery.  There are other co-morbidities, like hypertension, heart disease, sometimes sleep apnea, that also qualify you (along with BMI). 

I think you have to just start working the process, and it can sometimes be a long and frustrating one.  But, working the process is good preparation for what you need to do post-surgically and beyond.  So, it's good practice.

The other thing I would advocate is be honest with the surgeon and team, but also be persistent.  Sometimes, the "squeaky wheel gets the grease" and you need to demonstrate how committed you are to this.  That will often help to get you the documentation you need to meet the insurance requirements.  Sometimes they also consider previous diet history and how well/poorly you did with that.  My insurance had me go through 3 months of weight loss counseling/effort pre-surgery.  Some require longer than that.  Just stay positive and persistent.

Best of luck to you and keep posting about your efforts and their results.  People will respond to you and provid you with suggestions....they definitely will.  You are not alone with this.

I HAD LAPBAND SURGERY IN NOV.2008. I AM STILL DIABETIC.  I AM CONSIDERING HAVING THE BAND REMOVED, THEN A GASTRIC BYPASS.  HAS ANYONE HAD THIS DONE?  IF SO HOW ARE YOU NOW ?