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Trying to make a decision

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Old 09-25-2002, 11:50 AM   #1
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Default Trying to make a decision

Hi, everyone. I went to a WLS seminar last night and met one of the surgeons. I turned in all of my paperwork and now just need to wait for all of the insurance stuff to go through.

I know my insurance will cover the RNY; however, I just found out that the surgeon is getting lapband training in November. He might even be the first in our state to be doing this.

The problem is that insurance doesn't cover the lapband and I don't have 10K to plunk down for it. The lapband appeals to me because the intestines are left intact and there's no vitamin deficiencies, on the other hand, the weight loss is much slower and I'm a little afraid I would "cheat" with it.

With the RNY, I know I wouldn't be able to cheat with sweets unless I want to dump (ugh!) and the weight loss is much more rapid. Plus no insurance hassles. Plus a "cure" for my Type II diabetes.

I know the choice is ultimately up to me but I was wondering if I could hear from both surgery sides. Is there anyone with the RNY that wishes they'd had the lapband option? Anyone with the lapband frustrated with the slower weight loss? Thanks so much!
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Old 09-25-2002, 06:45 PM   #2
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jinkies... what a lot on your mind these days!!! and here are a few thoughts.

the lap band was tested at 8 sites in the US. obviously, utah wasn't one of them. this means that your surgeon, even though he will have been trained in the procedure, has no experience with the aftercare and no experience with actually DOING the procedure. and there can be serious complications.

my advice on this one: if you DO decide to go with the lapband, find a surgeon who's experienced in the procedure and aftercare. some folks are trotting off to mexico, with excellent results [and i'm hoping they'll check in and let you know about their experience].

i wanted the lap band, but i was too heavy. so that's another consideration. the fact that it was so much less invasive was very appealing. but not only is the weight loss slower, it's also not as effective as the rny, so fewer people hit their goal weights [whatever that may be].

the recovery after the rny was not pretty, and i had no complications to speak of. it's the 3 months of healing thing. but i just kept telling myself that it would end. and it did. and i'm not having any serious problems, as long as i keep up with the vitamins [i'm terrified of deficiencies] and the protein. it's not a bad lifestyle. i've found that i can eat small amounts of just about anything so believe it or not i don't feel at all deprived.

before the surgery, i was always limiting the types of food i ate: no cream sauces, no sauces at all in fact, limited cheese. whatever the diet du jour was.

but now, if i want chicken in a cream sauce i have it. it's just a few bites, but they're GREAT. and something i WANT to have, rather than what i'm allowed
to have. it's been a great boost for me.

and did they mention last night that your tastes change? it's the strangest thing!!! i used to LOVE pasta, and now it tastes disgusting. i still enjoy a couple of bites of good chocolate now and then, but it has to be GOOD chocolate.

so, as for how much i've lost and when and all that other stuff: surgery was january 29, and i've lost 141 pounds since then [although i need to get another weight soon]. and i'm down a total of 238 as of last week. i lost the first 97 pounds after they fixed my sleep apnea.

and there's finally less than 100 pounds to go!!!!

so, hope this helps. and ask more questions!!! this is a major big step for anyone, and the more you know, the better your decision, and the more prepared you'll be for whatever happens.
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Keeping it off is a hundred decisions a day that help you maintain what you achieved. And that's the hard part. - L Sanders

start: 506 [Sept 2001]
weight at gastric bypass [Jan 29, 2002]: 409
current weight: 225
weight for plastic surgery: 200
final goal: 180

Posts by members, moderators and admins are not medical advice. See your physician before taking advice found on the internet.
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Old 09-26-2002, 12:21 AM   #3
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Default A few more questions then . . .

Thanks for the info, Jiffypop. It's true I've been concerned about being a guinea pig for the bariatric surgeons here for the lapband. I don't know if they practice on cadavers or assist on a live patient. He is going to Tijuana for training but I didn't get a chance to ask him much about it.

I do have a couple of more questions for you.

I noticed you said that you can eat pretty much anything just in small amounts. About how many calories do you eat per day? How many grams of protein do you try to eat daily?

Do you/did you have the dumping syndrome? (you mentioned you can eat good chocolate and cream sauces).

How often do you get checked for vitamin deficiencies?

And lastly, any regrets? I know it's a very personal question but I'd really like to know. I only know 2 people who have had the RNY personally. The man I know didn't give up the diet Coke and he has regained all of his weight. It's scary to think that he took such a drastic measure to get healthy and cheated the tool. The woman has done exceptionally well--I know she was minus 115 lbs at the 6 month mark. That just blows me away!!! She looks great and says she would do it again in a heartbeat. Do you feel the same way? Would you do it again now knowing what you do? Thanks so much for your candor--I appreciate your willingness to share your story.
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Old 09-26-2002, 11:31 PM   #4
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oh jinkies. i'll be happy to answer all your questions but i really do hope that this isn't the only source of information you're using!! have you checked out www.spotlighthealth.com? www.obesityhelp.com? and the nurse who ran the obesity program i was in has her own website at www.partnershipinweightcontrol.com

and you can ask her all kinds of questions.

but, let's get to your latest ones.

first of all, everyone's reaction to this surgery is different. for example, i can't eat scrambled eggs. they come right up. but a deviled egg made with hot chili sauce is just fine!!! others have trouble with chicken, some with beef. there's no rhyme or reason to it.

and believe me, it takes awhile to get to the point where you're eating regular food. and the protein goals vary from doc to doc. the smart ones want you to eat a lot of protein, and use protein shakes. the inexperienced ones suggest that you use carnation instant breakfast. and i'm telling you, it's not enough protein.

the amount of protein depends on how much weight you need to lose. those with less than about 150 to lose were told to eat 60-80 grams per day. becuase i had so much to lose, more than 200 pounds, i had to eat 80-100 grams a day. now that i have less than 100, myprotein goal is 80 grams.

and remember, because the digestion and absorption are now altered, we don't absorb all the protein we eat. and apparently we can absorb only about 25 grams at a time. so those 50-gram protein shakes are a waste of protein.

don't let anyone tell you that this is easy. you MUST keep up with your fluid intake to help the weight loss and keep your kidneys working. but you can't drink 30 minutes before and 30 minutes after eating.

so, most folks who are successful at this have rather regimented days. they always carry water, often an insulated bag with protein snacks, or they know what they can get where. and they know where ALL the bathrooms are.

as for dumping. i really don't know if i dump!!! i've been too scared to try!!!! rule of thumb: most people don't dump on less than 15 grams of carbs or 15 grams of fat. so read the labels and watch the portions!!

one important point: make some effort to conquer your food demons beforehand. some people react with anger, others with sadness, and some even go into mourning over their lost best friend [food] who's no longer around.

and some of us approach it as just another eating plan, but this time it's one that actually works for us.

and i have no idea how many calories a day i eat. some wacko dietician said that we have to eat 500 or less, and i'm sure i did for the first month or so. since then, i 'know that it's increased, but i doubt that it's as high as 1000.

my main goals for the day are to make the protein and water goals. a piece of fruit, some vegs/salad, it's a second thought. we have to eat our protein first.

any good surgeon will set you on a regular schedule of follow up visits, with blood work along the way. some folks return to their PCPs for their follow ups, but i prefer the surgeon. this one really knows what he's doing.

in fact, i'm seeing him in two weeks for a 9 month follow up, and i had the bloodwork drawn this morning. lots of b complex levels to be tested, and iron. and this is the third or fourth time since the surgery that they've been checked.

last visit, he told me that my b12 levels had dropped, and i'm on oral b12. and might have to switch to the shots. not sure.

if you're still interested in the lapband, here's a thought. right now, the only one approved for placement in the US is made by Inamed, a california company. they're the ones who run the training. not quite sure why your doc is going to tijuana to learn, although i think there's a fabulous surgeon down there [i think one of the lapbanders here went to him].

anyway, maybe inamed could help you find a surgeon.

johnson and johnson has bought the swedish lap band company, and has filed for FDA approval on the basis that this lap band is the same as inamed's. no approval yet.

has this helped??? keep looking. make the right decision for YOU.
__________________
Start your day with a smile, and get it over with.
Keeping it off is a hundred decisions a day that help you maintain what you achieved. And that's the hard part. - L Sanders

start: 506 [Sept 2001]
weight at gastric bypass [Jan 29, 2002]: 409
current weight: 225
weight for plastic surgery: 200
final goal: 180

Posts by members, moderators and admins are not medical advice. See your physician before taking advice found on the internet.
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Old 10-06-2002, 06:20 PM   #5
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Default a word of support

Hi Friend,

I'm still pre-op...suppose to have surgery Dec. 17th. My surgeon only does the RNY so I don't have a choice. However, I think I'm glad this is the route I'm taking. Not to say anything bad about the Lap, but I'm ready for some good AND permanent results, and I think my chances are better of achieving this with the RNY. But, people who have had Lap seem to be happy with their choice. True, the RNY is more invasive, but, if your surgeon determines you aren't at any higher risk having an open surgery, then you should be okay. We're all at risk with any surgery, so it's a risk most of us are willing to take to become healthy. I have had 2 C-sections and my gall bladder out and have never had any complications. I was up and moving pretty well after just a week with my surgeries, although you do have to be careful and move a bit slower.

Anyway, just use the other websites Jiff listed for you, do your homework and make your decision. Just be informed so you know what you're getting into. I can't wait to have my surgery and get my life in order. I, too, have type 2 diabetes and I'm also looking forward to that going away!!!!! I just know life is going to be that much sweeter when I'm not carrying around 2 people anymore!! God Bless you as you learn and decide.

And Jiff.....my surgery date is still my original date. I think???? I will have it in Dec, but I still don't know for sure yet. I'm hoping to have a firm answer fairly soon one way or another. So, right now I'm being cautiously optimistic. Thanks for asking!

Just me...Robin
Pre-290
Surgery Date: Dec. 17th, hopefully!!!
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Old 10-08-2002, 10:36 PM   #6
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Jinkie; I['ve never had the surgery, but I have lived it vicariously through my DH Alvin. He had the laprosocpic RNY and his recovery was only about three days. He has lost about 150 pounds and is doing great. he can't tolerate meats very well, but most everything else is okay.
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Old 10-11-2002, 02:43 AM   #7
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Default Thanks for all of your input

Thanks for your input, everyone. I have actually researched both surgeries quite a bit. Right now, I'm leaning towards the lap-band because I would like to have another baby and the malabsorption of the RNY scares me a little. If I definitely weren't going to have another baby, I'd probably go for the RNY.

But, again, we'll see. I know neither is a "cure" for my weight. They're both tools to help me get healthy because I just can't seem to do it all on my own. I'll definitely post again if I get approved. Thanks again.
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Old 10-11-2002, 09:01 AM   #8
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jinkies... several women in my support group have had very healthy babies after their RNY, but they have to be monitored and very careful throughout their pregnancy, and that requires docs that are experienced with it.

one point about the lap band, although it's a gruesome thought, if you decide that it's not working, you can always have it revised to an RNY. a very personal, very involved decision.
__________________
Start your day with a smile, and get it over with.
Keeping it off is a hundred decisions a day that help you maintain what you achieved. And that's the hard part. - L Sanders

start: 506 [Sept 2001]
weight at gastric bypass [Jan 29, 2002]: 409
current weight: 225
weight for plastic surgery: 200
final goal: 180

Posts by members, moderators and admins are not medical advice. See your physician before taking advice found on the internet.
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Old 10-16-2002, 09:55 PM   #9
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Hi Jinkies,

I have the Lap-Band. I don't have a world of experience yet as I'm only 2 weeks post-op, but I do have a lot of information if you have questions. I have a very good friend who is 3 years Lap-Band post-op. She went from a size 26 to a 4/6. It CAN be done with the Band!

Yes, I have heard that weight loss is slower with the band. That is one of the reasons I chose it. I want to give my skin a chance to catch up.

I know of a gal with the RNY that is pregnant right now so it can be done. She just has to see a specialist and is monitored very carefully.

I think whichever surgery you choose, it will be right for you. I'm for anything to get the weight off.

I'll be happy to give you updates about me as I go along if you like. I was banded in Mexico by Dr. Rumbaut. I have another Doctor who will oversee my care here in the states. Perhaps your Doctor is learning in Mexico because some of the best Doctors are there and they teach the procedure.

Take Care,
Blondee
Dr. Rumbaut
10/1/2002
-23.5
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Old 10-17-2002, 09:50 PM   #10
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blondee...so glad you hear from you!!!! and it sounds as if you're doing great!!!!!

yep, the mexican [and european] docs have the most experience with the lapband, and their work allowed it to be explored in the US.

so glad people have an alternative.
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Start your day with a smile, and get it over with.
Keeping it off is a hundred decisions a day that help you maintain what you achieved. And that's the hard part. - L Sanders

start: 506 [Sept 2001]
weight at gastric bypass [Jan 29, 2002]: 409
current weight: 225
weight for plastic surgery: 200
final goal: 180

Posts by members, moderators and admins are not medical advice. See your physician before taking advice found on the internet.
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Old 10-18-2002, 02:13 AM   #11
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Hi Jiffy!

It's nice to hear from you again too. I'm happy the WLS forum has taken off like it has. At least people who are curious will get some info here. I'll have to read more of the forum, but it doesn't seem like there are too many negative comments about it. That's great!

Right now during my liquid phase it can be difficult, but no one ever said losing weight was easy, no matter how you choose to lose it. At least when I chose my Lap-Band there wasn't a little comment by the success stories saying "Results not typical" like there are on a lot of the other diet plans. LOL.
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