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Hi this is not my post but these are also the questions that i seek
Hi! I'm new to this site - again! Haven't been on in years. I had an RNY in July of 2001, and I highly recommend my surgeon and the procedure. I have had a few complications indirectly related to my surgery, but nothing that I blame the surgeon for. I had a hernia, which is common after an open surgery - but I got an all-expense paid tummy tuck because of it, so I'm not complaining! I rejoined today because my best friend's daughter is looking into WLS, and I wanted to see what's new and different since 7 years ago. My friend was reading about the MGB, and I wanted to see if anything has changed in the procedure. It doesn't sound like it. As long as I'm here, I can give you some insights as someone who was there kind of from the beginning. I think that 30 revisions number is may be the number of revisions Dr. Rutledge himself has done, but everyone I know who had a revision had it converted to an RNY by another doctor. I can think of 5 people I knew who had revisions back then - about one year post-op, plus another lady who had to have Dr. Rutledge do a take down due to severe anemia. That was when Dr. Rutledge was the only one doing the surgery, and there had been about 800 total. There has always been an awful lot of argument about the MGB, which I first researched back in 2000, when it was brand new. It seems that most people are happy with their weight loss, but the people who I knew who had complications were seriously ill. I had a friend who had complications and almost died before having a revision to an RNY. I knew another woman who couldn't work. If you understand anything about plumbing, you can look at the MGB and see exactly why some people have reflux problems - the intestine, which is filled with bile, which is an alkaline base, is connected directly to the pouch/stomach. As long as people are standing up, it's fine, but since there is no flap (pyloric valve), the alkaline bile can back up into the stomach when someone is lying down. Think about how your sink would drain if you laid teh plumbing on its side. In most people, it doesn't seem to be a problem. But in the people I knew who had the reflux problems, it was explosive - really unbelievable and horrible to see - like projectile vomiting squared. Basically, when the alkaline bile meets the stomach acid, the same thing happens as when you pour vinegar on baking soda to make a volcano for your kid's science fair project. Many people back then were complaining that they had to sleep in a recliner, but it seemed to get better for most of them further post-op. Obviously, the vast majority of people must be satisfied, and have no problems with their surgery. Since bile and acid will ultimately neutralize each other, I imagine that's what usually happens. The thing that actually put me off the most was research I did on Medline. The old Bilroth II was not abandoned due to bile reflux causing indigestion - it was a surgery to treat ulcers and acid reflus problems, so whatever complications there were couldn't have been very widespread. But Medline reported several studies linking the Bilroth II to a scary increase in stomach cancer - with an average onset of 22 years. Dr. Rutledge seems like a very sincere man, and he is absolutely convinced that his modification to the stomach - the vertical, rather than horizontal design, will solve all the problems. He may be right in most cases, but just because the bile is mixing with the acid way down in your stomach, where you don't feel pain, as opposed to up in your esophagus, this doesn't necessarily eliminate the cancer issue. Dr. Rutledge sincerely believes in his surgery, and I don't think he'd continue doing it if he was seeing a lot of complications, but in talking to him, I discovered that the figures for complication rates on his website were somewhat misleading - at least to me. He only reports surgical complications that occur within 30 days - things like a hernia, which would be very unlikely with any lap surgery, or internal bleeding, an infection - things like that. He never reported the complaints that people had post-op as a result of his procedure. He didn't believe the MGB caused it, he blamed the patients for not eating right - which may have been a contributing factor, for all I know. He said intestinal bile in the stomach was not a problem. It seems that most other surgeons, including those at Mayo and Johns-Hopkins, disagree. Dr. Rutledge says it's just professional jealousy, or stodgy old doctors wanting to do the same old thing, but the MGB is a Bilroth II, despite his minor modifications - if it weren't he'd have had to test it on animals or something besides human guinea pigs. His insurance code - which may have changed since then - was the standard code for a Bilroth II. Back in 2001, when I had my RNY, insurance companies generally wouldn't pay for the MGB because a Bilroth II wasn't an approved weight loss surgery - although they would have covered it for other reasons. I don't know what the status is now, but the insurance companies refusal to cover it had nothing to do with any complications or complaints about the surgery. The comment about Dr. Rutledge not having insurance was probably a misunderstanding. I don't know how he does it now, but back then, he wouldn't process insurance claims, even if your insurance company might pay for all or part of the surgery. You had to pay him up front, and then do your own insurance filing to get reimbursed. I imagine that was what the poster was referring to. I just have to say one thing in defense of the RNY - It is also done in slightly different ways, with different results, so i would encourage anyone who's considering it to check with their doctor, and see exactly how they do it, and read up on the differences. But, it's not fair to compare complication rates or death rates for the MGB to an RNY straight across the board. The MGB is only done on relative lightweights, and those people are typically better candidates for any type of surgery - the heavier the person, the more likely it is there will be complications. My doctor performed a successful RNY on an 800 pound man, and that happens every day around the country. Also, until recently, almost all RNY's were done open - I don't know what the percentage is now, but really heavy people can't have the lap surgery, and complication rates will always be much higher for an open surgery. MGB's are never done open - a patient who weighs too much just can't get one. Also, the relative lightweights - people with only 100 pounds or so to lose, always have better results with any type of WLS. The heavier people are fighting a bigger genetic battle. I eat anything i want - seiously, anything - but I just can't eat too much. It doesn't take much to fill me up, but I often feel like I overeat, so I honestly can't see how people stretch out their pouches - it's just too painful to overeat, even a little bit. But, I don't see why the MGB would be any better than an RNY in that respect. The muscles that must contract in order to let your brain know you're full are at the very top of the stomach. The pouch is a lot larger on the MGB, and I honestly think RNY surgeons and patients take the wrong approach, making the pouch so small that the patient is so limited in eating. From the post-op discussions I've had, it seems that the biggest problem with RNY patients is that they starve themselves, instead of eating a lot of little meals, and they wind up skipping meals, getting very few calories, and shutting down their metabolism and gaining weight on 600 calories a day! The last thing I'd like to say is I don't think anyone should rely too heavily on CLOS.net, or any other surgeon's website, when trying to get the facts about any surgery. Those web pages are there to sell surgeries, and the information is certainly slanted to make their own surgery look the best, and make all the others look as bad as possible. It's much better to get MGB info from an RNY doctor, and RNY info from an MGB doctor, etc., because you'll certainly get a more honest view of the downside that way. And, it's very important to do your research, and know aht surgery will fit your post-op lifestyle - and what sort of risks you're willing to take. Forums like this are great places to find information. Since I just joined, I don't know what all the forums are, but before my surgery decision, I lurked for about a year on several sites, particularly the Graduates site for people at least one year post-op, where I could really get a feel for what life was like, what problems people had, a year or two, or five post-op. You also have to remember, for the most part, the only old timers you'll see online are the people who are having problems of some sort. People like me, who have no problems, lose interest after a while - once your surgery just becomes a part of your past. Anyway, sorry for being so long-winded. I wanted to add my two cents about the MGB, but I guess I put in more like a few dollars! What I'm really trying to find out now - and all you newbies who have been researching this stuff probably know - what's the trend now? Other than the MGB, are things shifting to any of the newer surgeries? There was a lot of talk back when about DS and BPD(?) - I can't remember if that's right. My friend's daughter is very young - 20 years old and in college in Texas. She has always had a weight problem, and she got a lap band a few years ago, when she was 16. She weighed over 300 pounds at the time, and she should probably weigh around 150. She has probably lost about 50-60 pounds, but she's still very heavy - definitely over 40 BMI - probably still weighs in the upper 200's. Of course, who knows how heavy she would be if she hadn't had the band? She says she feels hungry all the time, and just eats really slow and drinks lots of water, and outeats her band. I think she's either got an eating disorder, or it may be head hunger, or maybe 16 year old kids just aren't mature enough to have any WLS. Any RNY like mine, where the stomach is completely severed into two pieces, doesn't produce an enzyme that creates that hungry feeling, but she insists that she's hungry all the time. So, now, they think it's time to do something more serious. I am very happy with my RNY, but I was wondering if a DS would be better for her, since you can eat more? But, I saw some negative comments here about the DS - what's the deal with that? And, whatever happened to the BPD? And the gastric pacemaker? And what in the heck is a gastric sleeve? And, is insurance still pretty much only paying for the RNY? Are people having problems getting insurance to pay? Back when I had my surgery, one reason I didn't wait an extra few months to have it done lap was that I was getting nervous - it seemed like the insurance companies were trying to pull the plug on WLS. If anyone can kind of give me an overview of what's going on now, it would save me a lot of time researching! Thanks bunches! Lily
I got an article from SparkPeople about emotional eating. I know that it's been an issue for me in the past... not so recent past to be honest. As many of you know, I've been under an enormous amount of stress lately... Well, actually for the last year or so, but it's really ramped up during the past 3 months. During the past year, I noticed that I was succumbing to emotional eating and put on 15 to 20 lbs... I had dropped a little low before, so i was only worried about the last 10 to 12 lbs, but I was comfort eating. I recognized what was happening that was able to identify the problems and trim off the extra 10 to 12 lbs. I found that if my weight is going up, I seem to be able to get a handle on it by logging what I'm eating. It allows me to 'see' what I'm doing and make the appropriate corrections. I didn't really have to 'diet' to the excess weight off, I just made sure that I was leading with protein and keeping my carbs under control. For me, it seems that when I let my carbs get out of control, meaning more than 30% of my total intake, then I gain, but when I can get back in line, the extra pounds just trim right back off.
Being able to see it in terms of balance rather than having diet has made a huge difference for me.
During the past 3 months, I've actually dropped another 12 lbs and I'm a little too thin. Now that I'm REALLY STRESSED, believe it or not, I've found that I have to force myself to eat. Who would have ever thought that would happen.
If you'd like to see the article that SparkPeople have on emotional eating, click here.
Please share any thoughts and/or experiences you have surrounding emotional eating.
Thanks,Barbara
ObesityHelp Coach and Support Group Leader
http://www.obesityhelp.com/group/bcumbo_group/
High-264, Current-148, Goal-145
I am 25 years old 5'10". I have had lap band done in my country here in Canada just a little over a year ago.I was 260 lbs when i got the band i went down to 160lbs wasnt easy a lot of vomitting and everything that comes with the band.Another unfortunate thing is that i learned how to cheat the band its very easy a one just need to have fluids while you eat.I tried really hard not to over eat but with the band you never feel full its only pain that cause you to stop now i have developed another problem that it really hurts to eat solids so i only eat mushies even after 4 defills.
So my conclusion is to have a revision as band causing alot of pain and eating disorder and because of that i have gained some pounds and i am 178lbs now.
I personally like the MGB and the information thats available out there about MGB but the only thing i am scared off that i am only 178lbs if i do get MGB i could die with excess weight loss but i wouldnt want sleeve because i know i will not do good with ibecause my stomach is monster i can eat all day and can gain 40 lbs in a month no problem.My weight is uncontrolable
Part of my question is which surgery should i get or should i wate untill i gain a lot of weight which i am gaining very rapidly now,because the only thing goes down easily is ice cream cookies milk carbs.
my other question is to MGB ers out there if i get MGB and i do loose 40 lbs or wht so ever can i change my eating habbits not too loose any more as i have lost a lot with the band.
Please help me i have been crying over nights because of my situation and all my family depends on me i dnt want to do any stupid decision rather than informative the doctor i am consulting in mexico performs them all and he said it your own choice.
I have spent 18000$ already on band and dnt want to make a decision where i ll have to do another surgery which i do not have finances for.
I just want a revision from lap band because its hurting too bad and the doctor said if it gets erosion i ll have to pay for two surgeries once removal of a band and then to wait for 6 months and then do any other surgies so i wana do it quickly that way if its not eroded already it wont get a chance.
Its not that i failed the band if it was it i wouldnt have ost 100 lbs in first place.Fills fills fills defills defills its un predictable gets tighter when its cold gets looser when its hot get tighter when u r flying or on a hight very tight in the morning its a device doesnt seem to work for human body
why there is nor cure for this why it seems end of the world
I am ten years out with the MGB and would do it again in a heart beat. This is a very powerful surgery. Dr. Rutledge has an online clinic on UStream every Tuesday at 12 noon eastern time. You can listen, watch and learn a lot about the MGB. He also has many things on Twitter and YouTube. So you can learn a lot about it. With any surgery, there are risks. I don't care if it is toe surgery, there are risks. So, keep that in mind.
With ANY of the weight loss surgeries, they are only tools to a healthier you. However, these surgeries are not the cure. Meaning, dealing with the issues that brought us to the point of being obese. Whether it's a childhood trauma, a bad relationship, a long illness or something more recent. We need to face our demons so to speak. We have to go through a whole body healing for any wls to be a success.
I hope this helps.
Thank you for your response.
I am living with the failed lapband too.
How much does he charge for to remove it and do the MGB?
And what financial company was that available for you to use?
I just had a MGB in Juarez Mexico with Dr. Jose Rodriquez. My experience was that the hospital Start Medica was clean the doctors attentive and spoke good english. On the other hand the nurses and assistants did not and I had a difficult time communicating with them. I went alone, having traveled alone and having had (failed) lap band surgery in the US before thinking I would be okay. I felt isolated and alone. Bring someone with you if you can. They could have stayed right in my rooom which was large, had a pull out bed and comfortable recliner and nice bathroom facilities. Unless of course you speak spanish. I also found the trip exhausting from Florida I flew to El Paso and drove over the border but had connecting flight in Atlanta. On the way back I (thankfully) had arranged wheel chair assistance with the airlines which worked out beautifully since I would have been too weak and too slow to switch flights getting from terminal to terminal. The airline even upgraded my seats. Make sure you set that up for yourself if you are flying. I am recovering well at home and would be happy to answer any questions you have. I wish you blessed success! (PS I could not afford the rates in the US either and Mexico was much more reasonable and affordable)
Scott Steinberg, M.D., F.A.C.S.
1045 Sycamore
Second Floor
Decatur, GA 30033
Phone: (404) 501-7903
Fax: (404) 501-7981