Let's talk about risks...

oldpolly1
on 4/10/05 2:17 am - Gold Canyon, AZ
OK, you guys, we all have heard about the risks related to the different methods of WLS. How did you guys who have done this weigh the various risks and come up with your decision? I am leaning towards lap band because of the low risk, but want to be a successful as many I've seen who've had the RNY. What about proximal vs distal? Doesn't the distal's malabsorption worry you? I'm afraid to lose my hair, my gall bladder, my health. Any and all thoughts are appreciated! Bonnie
Gail T.
on 4/11/05 2:39 am - Alvin, TX
Bonnie, the surgeon I consulted does both and he told me the decision was up to me and he would not try to influence me. He did say that in 2-3 years the results were very similar. He is aggressive about fills for the banding. Unfortunately my husband's company won't cover it on their insurance. But my choice would definitely be the lap band for the very reasons you noted. Gail
Caryl Mauk
on 4/11/05 3:30 am - Manor, TX
RNY on 06/26/06 with
Hi Bonnie, I think of it in terms of the risk of the surgery vs. the risk of remaining morbidly obese. I have several major co-morbidities and am practically guaranteed to develop diabetes with all its complications. I believe either RNY or Lap-Band are less risky than staying this fat. I am seeing my surgeon for the first time tomorrow, so I haven't had a personal conversation about RNY vs Lap-Band. At the seminar I attended prior to making an appointment, the surgeon presenting the info also said Lap-Band compares favorably to RNY in the long term. Good luck. Caryl
debi327
on 4/11/05 10:20 am - Henderson, TX
Bonnie, I did a lot of research (about 5 years) before I went to see a surgeon. he met with us as a group and then individually. He said he does not do lap band because your chances are not near as good as RNY. SOOOOOO, I went for RNY. Open RNY d/t previous Nissen Fundoplication. But.....I had many complications. I am 5 1/2 months out and am finally able to ear pretty good. During my surgery, which was only supposed to last 1 1/2 to 2 hours, the doc nicked my spleen and had to take it out due to the "moderate about of bleeding". He also nicked my pancreas and they did get that stopped with a mesh. I had totally uncontrolled pain after surgery (probably due to the pancreas???), and the Recovery room nurse "forgot" to hook my PCA pump up to me. It was running out on the floor for 2 1/2 hours. I screamed for those 2 1/2 plus hours. On day 2 I got to try clear liquids. On day 5 my temp is elevated as well as WBC so down for a CT. I had a "grapefruit sized" abcess. Went back to CT and had it drained. The sedation didn't work (My IV was out of the vein) so I screamed through that procedure. The doc said, as I was leaving, "Now let's just hope she doesn't remember that." I did and I do. I had 2 JP drains, and a G-tube, which was put in during surgery.."just in case" I had to be transfused and went home on O2 and Home Health. Soon after getting home, I noticed the drain had "particles" in it. When I ate an egg, particles of it would show up in the drain. I had an anastomosis leak. I had to go 4 times die to a stricture. After 4 1/2 months I finally got all of my tubes out. Now...I said all of that to say this. Go for the lap band. I DO NOT and never will recommend Open RNY. I had to have something due to major health problems, but I wish I had been going into with full information. Most people don't want me to say anything because it "might discourage someone *****ally needs the surgery." My reply is."I wish someone had told me that ALL of the complications could happen to the same person. The doc said.."I guess we can just chalk this up to your bad stomach." I hope I have not frightened you. That is not my intention, but you asked so obviously you want to know. Just to let you know that I'm not just a "wuss" (Spelling) I have had several surgerys prior to this one and I always was ready to get right out of the bed and get in the hall and begged to go home before time, this was just so much as the same time. My O2 sat would drop drastically when I tried to walk down the hall and I just couldn't do it. Good luck to you and feel free to write if you'd like...debbie
Sandra T. RN
on 4/12/05 11:12 am - TX
Sorry about your experiences Debbie. Sounds like you had some pretty shabby nursing care. I'm not real impressed that your doc blames your stomach on his nicking your spleen and you getting a leak. Hope things get better for you.
Sandra T. RN
on 4/12/05 11:22 am - TX
I'm pre-op but these are my reasons for chosing RNY in no particular order. That's what we do at the hospital I work at. Our insurance covers the procedure. I know the doc. We have a very low complication rate. I have read too many posts about being able to eat sweets with the lap band. I am doing this with the hope that I will dump on sugar. Good old Pavlov and that dog of his, LOL.
pfrigy
on 4/13/05 12:55 pm - Stow, OH
I was in the same boat as you. I had been a CCU (floating to ICU) nurse and fully believed I might not make it. I did a ton of research. The sugar problem is what made me choose the RNY. I KNOW that I would have a great chance of regaining the weight if I could tolerate sugar - luckily I dump on it. I can eat sugar gum and for some reason hard candy, but other than that, forget it. I was mainly concerned about the complication rate with the surgeon I picked and the hospital I went to. They furnished me the statistics willingly. One of my friends (age 54), also a nurse, had an open RNY, and did not have a sleep study ahead of time. She did 2 days in the ICU primarily for respiratory, but is excellent now and swears by the surgery (she is about 100 pounds down). I would also ask about the preop testing - they should do a lot to make sure the risks are evaluated you know? I had a lap RNY, and had a BMI of 49.9. I am now 138 pounds down. I asked my family doctor (Internal Medicine) if she had heard of any post op long term complications from the surgery and she said she had just had one pt that was done in 1978.. (yeah, I know I said no way, they did not do this surgery back then!) - but they did some kind of weight loss surgery on him and this year he started to lose too much weight again and she said they had to reconnect him???? So that is the only long term thing I have heard. She also told me that they have done this surgery for quite some time, but did it for stomach cancer - so they do have statistics but not much for surgery done strictly for obesity. I had a pretty uncomplicated recovery, for me it was the best thing I have ever done in my life - I just did not like the liquids for the weeks after the surgery - yuk. I pretty much eat whatever I want now, I do protein first, then veggies then carbs. I just never want to regain it. I know more people are doing the lap band, but I just don't have any self-control - I really liked to eat too much food, and it was emotional eating you know? Like stress would trigger it. Whatever you decide, good luck and best wishes!
oldpolly1
on 4/13/05 3:20 pm - Gold Canyon, AZ
Thanks to all for your input. I didn't realize the issue re: sweet thing. I'll have to do more research on this. They are really my downfall, so being able to eat them would be a bad thing! I'm off to do some more reading! Bonnie
Diane L.
on 4/18/05 9:53 am - O'Brien, OR
I am probably too late to help you. I needed something that was absolutely permanent-so I did the RNY. However I have been working on a research project through Medline and Medscape. And from the reading I've been doing distall is not quite as good, more nutrients lost than proximal, and a little more complicated surgery-wise. Also you are considering doing it Lap, right? Guess what, your hair will grow back and you can always get a wig from Paula Youngs for 20-30 dollars. You can even play around with wild colors you wouldn't have done to your own hair. Gallbladder.....hmmmmm.....I would absolutely insist it come out during the surgery if I had it to do over. I had to have it removed 3 months later because I was so sick. Have you seen an Actigall capsule? It is like trying to take a horse pill.....and I couldn't. Is there a down side to loosing the gallbladder ? Not for me. Your bile will kick in a meter later than you are used to at the present. I find that to be very painful, that one little extra meter waiting for the bile to come on board, so that keeps me counting fat grams and keeping everything under 3 grams. That's the most I can handle in one eating. There is a fantastic upside to this. Fat is more concentrated calorie-wise. So I lost weight faster, not being able to tolerate fat. And I can splurge in other areas. Like JellyBellys. no fat, and the extra sugar is offset by the fat most people would have had in a regular meal. Hope this helps Di
N'Awlins Kat
on 4/23/05 6:17 pm - TX
I spoke to my surgeon about how far distal he goes and his opinion. He said he does the 150cm cut but he personally feels that it's more the pouch size than the malabsorption that affects the permanence of the tool. He did also go into his extensive experience (More than 3100 RNY procedures done over a 20 yr span, and not one death). He also noted that Lap procedures are the most common and that even those with scar tissue from prior abdominal surgeries could still get lap if the scar tissue had not adhered the omentum to the organs. At any rate, he seemed very knowledgeable and willing to discuss the procedure and it's details with me at length. I was very pleased to be treated as a fellow medical professional, rather than a "lay person."
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