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Thanks for posting this!! Here's another Oregonian headed to Mexico...Scheduled for Memorial Day w/Dr Aceves for revision of Lapband to VSG. Trying not to be nervous

Hello, I have a lap band and am seriously considering revision to gastric bypass. With the lap band, I have by far the most restriction with my first meal of the day. If I’m going to get stuck, overly full, or throw up, it’s almost always with breakfast which can set off a chain reaction throughout the day. I know the surgeries are very different, so I’m curious if people with bypass notice differences in their ability to tolerate food throughout the day. Thanks!

I lost most of my weight with the band but gained some back when I started having band problems. I weighed 167 the day I had my revision surgery and I weigh 130 now. I basically had no recovery. I was walking around outside the hospital the day after surgery. I had surgery on a Wed. and went back to work on Monday.

First of all why wouldnt she see her surgeon in a year. The first five years post op are important to maintain with your surgeon. I moved and found another surgeon who took me in as a patient all he wanted was my op report and to know I didnt have an complications after surgery. He sees me regularly and is very nice. Everyone will not like their doctors or the care they get for some reason but I think it is also our duty as the patients to remain in contact with our surgeons at least yearly once banded. You need follow up care. If you are not willing to travel to see that surgeon then you need to find one that will follow you and as long as it is after care and not to redo the surgery then most surgeons will take you on as a patient as long as you are not asking them to revise what another has done.

I had the revision on Tuesday 9/27, still feeling under the weather, can't seem to get enough fluids in, trying to drink but so hard. Stomach still very sore especially the one large site. Also doesn't help I have a cough, so every time I cough hurts worse. How long did it take to get enough fluids in? Sent from my iPad using the BariatricPal App

I was banded in 2009, lost about 80 pounds total, then started to have major issues and had to have surgery to repair it in 2012. It hasn't worked since then and I've gained over 50 pounds back since then. My new doctor does not do the revision in one go so he removed my band in Feb 2017 and I'll get my sleeve surgery on Nov. 1. I'm thrilled that after going through all the hoops my insurance finally approved it.

It is hard when you see so many people post how quickly they are losing. I had revision surgery 2/4 - no pre-op diet and have only lost 11 pounds. I'm starting to get scared to face the scale and keep thinking I should stay off Bariartic Pal so as not to get frustrated reading about everyone's success but at the same time I need it to see I'm not alone

I had the sleeve done 7 years ago and developed horrible GERD with extensive esophageal damage. Tomorrow morning my surgeon is revising me to bypass as it offers the best chance to get rid of the GERD. Sent from my Z6201V using BariatricPal mobile app

I got the lap band done 3-29 this year and I'm over disappointed/frustrated with my weight loss so far. I'm down 20 lbs but I'm also up and down 2 lbs constantly. I feel like I have to fight for every single ounce. All foods are high protein and almost no carb or sugars. If I ate more than 1000 calories a day it's very rare. I keep a food log everyday. I don't think I should have to struggle for every single lb with weight loss surgery! I'm considering talking to my Dr about having a revision to the sleeve. My concerns with the sleeve.....I have 2 relatives that had it done and they've started gaining weight back. Am I giving up on the band too soon?? Is the sleeve any better?? Advice please!!

Hi Everyone, I came across this on a google search this morning. Apparently, the Department of Defense has finally ruled to not disqualify particular types of weight loss surgery, but just requires it to be medically necessary and particularly points to using BMI as a determination (but doesn't specify exactly how) Here's the link to the Federal Register for TODAY - FEB 14, 2011 Federal Register http://www.gpo.gov/fdsys/pkg/FR-2011-02-14/pdf/2011-3207.pdf Looks like it is effective March 2011 I cut and pasted here also in case the link doesn't work. DEPARTMENT OF DEFENSE Office of the Secretary 32 CFR Part 199 [DOD–2008–HA–0057] RIN 0720–AB24 TRICARE Program; Surgery for Morbid Obesity AGENCY: Office of the Secretary, DoD. ACTION: Final rule. SUMMARY: This final rule adds a definition of Bariatric Surgery, amends the definition of Morbid Obesity, and revises the language relating to the treatment of morbid obesity to allow benefit consideration for newer bariatric surgical procedures that are considered appropriate medical care. The final rule removes language that specifically limits the types of surgical procedures to treat co-morbid conditions associated with morbid obesity and retains the TRICARE Program exclusion of nonsurgical interventions related to morbid obesity, obesity and/or weight reduction. This final rule is necessary to allow coverage for other surgical procedures that reduce or resolve comorbid conditions associated with morbid obesity and the use of the Body Mass Index (BMI), which is the more accurate measure for excess weight to estimate relative risk of disease. As new technologies or procedures evolve from investigational into generally accepted norms for medical practice, the statutes and regulations governing the TRICARE Program allow the Department to offer beneficiaries these new benefits. These changes are required in order to allow the Department to provide these newer technologies and procedures for the treatment of morbid obesity as they evolve. DATES: Effective Date: This rule is effective March 16, 2011. ADDRESSES: TRICARE Management Activity, Medical Benefits and Reimbursement Branch, 16401 East Centretech Parkway, Aurora, CO 80011– 9066. FOR FURTHER INFORMATION CONTACT: Gail L. Jones, Medical Benefits and Reimbursement Branch, TRICARE Management Activity, telephone (303) 676–3401. VerDate Mar<15>2010 14:08 Feb 11, 2011 Jkt 223001 PO 00000 Frm 00030 Fmt 4700 Sfmt 4700 E:\FR\FM\14FER1.SGM 14FER1 WReier-Aviles on DSKGBLS3C1PROD with RULES Federal Register /Vol. 76, No. 30 /Monday, February 14, 2011 /Rules and Regulations 8295 SUPPLEMENTARY INFORMATION: I. Background On December 27, 1982, the Department of Defense (DoD) published a final rule in the Federal Register (47 FR 57491–57493) that restricted surgical intervention for morbid obesity to gastric bypass, gastric stapling, or gastroplasty method (excluding all other types) when the primary purpose of surgery is to treat a severe related medical illness or medical condition. The severe medical conditions or illness associated with morbid obesity included diabetes mellitus, hypertension, cholecystitis, narcolepsy, Pickwickian Syndrome (and other severe respiratory disease), hypothalamic disorders, and severe arthritis of the weight-bearing joints. The DoD also limited program payments to two categories of patients: (1) Those who weighed 100 pounds over their ideal weight with a specific severe medical condition; and (2) those who were 200 percent or more over their ideal weight with no medical complications required. Program payment was made available as well in cases in which a patient, who originally met the criteria, received an intestinal bypass, or other surgery for obesity and, because of complications, required a second surgery. Payment was allowed even though the patient’s condition may not have technically met the definition of morbid obesity because of the weight that was already lost following the initial surgery. All other surgeries including non-surgical treatment related to morbid obesity, obesity, and/or weight reduction were excluded. The DoD used the definition of morbid obesity, which was based on the Metropolitan Life Table and used then by other major health care plans, as well as reflected the 1982 general opinion regarding which cases justify surgical intervention. The DoD decided, at the time, that it was necessary to be very specific in benefit parameters due to fiscal responsibility and to ensure that Program beneficiaries were not being exposed to less than fully developed medical technology or procedures. At the time the current regulation was written in 1982, gastric bypass, gastric stapling, and gastroplasty methods were the recognized surgeries for morbid obesity. However, in recent years, other bariatric surgical procedures have evolved and some have a substantial body of literature to support their safety and efficacy. Unlike the original rule that listed the specific surgical procedures and the clinical conditions for which coverage may be extended; this final rule authorizes benefit consideration for those bariatric surgical procedures that have moved from the unproven status to the position of nationally accepted medical practice, as determined by the Program standard of reliable evidence. Also in 1982 during development of the current regulation for morbid obesity, overweight and obesity were typically measured with height-weight tables (such as the Metropolitan Life Table). The 1982 regulation restricted eligibility for bariatric surgery to individuals who exceed their ideal weight for height by 100 pounds with an associated severe medical condition, or 200 percent or more over their ideal body weight with no associated medical condition required. This final rule changes the Program definition of morbid obesity to reflect the current nationally accepted medical use of the BMI, rather than the typical assessed height-weight table (i.e., the Metropolitan Life Table), to determine an individual’s eligibility for bariatric surgical treatment. The BMI is the more accurate measure for excess weight to estimate relative risk of disease. Since there now are more than 30 major diseases associated with obesity, the final rule requires the Director, TMA, to issue specific criteria for co-morbid conditions exacerbated or caused by (morbid) obesity, as determined by the Program standard of reliable evidence. This final rule does not expand the TRICARE benefit for morbid obesity surgery. However, it does make the specific procedures that are covered, as well as the clinical conditions for which coverage may be extended, a matter of policy. In other words, new bariatric surgery procedures may be added to the TRICARE benefit structure as such procedures are proven safe and effective and are established as nationally accepted medical practice as determined by the Program standard of reliable evidence.

Looks like I may be an AUGUST sleever, too! I have done my psych evaluation, chest X-ray, primary care doctor visit, and abdominal ultrasound. I have my EGD consult tomorrow and sleep study consult next week. Moving right along. I will be doing a revision from the band.

Hi I had gastric sleeve 4 years ago and didn’t have pain you are experiencing however, because of GERD, had revision to bypass . Then everything you describe was my painful experience like others had all sorts of tests when still there at week 4 which revealed nothing. At week 6 , I moved awkwardly and something ripped. I was in agony for 2 days . Then 2 days after that, all pain resolved met with surgeon and he told me that he had double stitched the muscle as he was concerned about hernia risk. Its worth getting checked out but if they find nothing , then it is part of healing process hope you get better soon

Hi, I am from Australia and had a sleeve done in 2011. I then had revision surgery in June and had the SADI or I am guessing the “mini bypass” it’s the loop but with only one join if that makes sense? Anyhow, it is very new here and I was only the 3rd patient my surgeon had performed this particular surgery on. I have healed well and lost weight but I am struggling with constant bloating, excessive gas and abdominal pain. Has anyone else had this problem? I have tried somac plus degas medications, ibs medication etc but it just keeps reoccurring. Help, I have just started dating again and this is going to be an issue so any suggestions would be greatly appreciated. Many thanks 🙏

There's a learning curve with RNY just as there is with band and sleeve...as a revision to RNY I never got that awesome 10 pound a week weight loss some others do, I think I maxed out at 3 a week a time or two, very similar to my band loss (dammit!!) (off topic, if anyone has data to explain why revisions lose slower I'd love to see it!!! My surgeon warned me, my personal experience says the same. I assume it's because my body has gotten smart from the previous ups and downs and knows how to conserve every ounce it gets but really have nothing to back it. If you read the RNY boards (which I encourage, cuz again, we're all in the same boat essentially) at some point between months 3-6 there tends to be a rather long stall then a significant slow down in how fast weight is lost. If you've done the lifestyle changes things pick back up, if you haven't then they slow way down. The thing with Amy of these surgeries is that the surgery is only a small part of the equation. Long term, eating healthy and exercise are what will get you to goal and keep you there, the surgery helps for sure, but it's not magic. Two of my best friends are sleevers who have lost next to nothing over 2 years...they don't exercise, one lives off soda. This equation doesn't add up to weight loss. I have at least 2 acquaintance that are years post RNY and are around 300 and 400 pounds respectively...they had decent success initially but again, being parked on your ass with a Big Mac and big gulp does not work long term. I am VERY direct with my patients about this before I refer them to a bariatric surgeon. They look at me and think damn that was easy but in reality I'm 40 pounds from goal and work hard for what I lose....the RNY helped (couldn't have done it without it!) as did the band in step 1, but the majority,of this was hard earned

Hello there! I’m having a revision aswell, I’m nervous and scared yet excited, how was your recovery? How long did you stay in the hospital?

If your insurance doesn't have any restrictions on the number of WLS per lifetime (some limit to one WLS per lifetime) then the usual insurance rules generally apply - BMI of 40 and above, or 35 with comorbidities. So, that's the good news - if you were covered before and have regained to that point, then you should be covered again. The bad news that you probably don't want to hear is that it won't likely do you much good in the long term, unless there was something seriously defective with your first procedure that needs to be corrected. Changing to a bypass may get you back on track again for a while, but ultimately you will be in the same position as the two procedures are very similar in overall strength or outcome. Think of your WLS as more of a "do-over" than a metabolic reset - it gives you the chance to get things in order to live sustainably and maintain your weight, but it doesn't do it for you. While I don't agree with everything this doc says, he is one of the few that acknowledges that our meal capacity will increase over time (to around half of our pre-op capacity), and has a viable prescription for living with that fact. His numbers are consistent with my experience over the years. Also, that sleeve/pouch size has little to do with long term capacity or success - my wife has a huge sleeve on VSG terms (from her DS, which typically uses a sleeve of about twice the size of a stand alone VSG sleeve,) and our meal sizes are pretty much the same several years out. It is very much a matter of food choices and habits rather than absolute restriction minimizing how much we eat. A good part of the game here is matching the right procedure with the patient - think in terms of the WLS procedures having somewhat different personalities, and you have to find the right "fit", just as you do with friends and associates. The RNY isn't any mover powerful overall than the VSG, but may be a better fit for you. Or it may not - research and talk to as many people with the bypass as you can to see if it is right for you, as one of its' drawbacks is that it is very difficult to revise to something else if it doesn't fit. With either procedure, it would not be uncommon for women of average and below height to maintain in the 1000-1200 calorie range long term. If you are having problems at 12-1500 calories now, a bypass or resleeve isn't going to help much if you can't find a way to maintain at whatever level your metabolism dictates. The DS does offer a better metabolic kick long term and may be your best option if you can't make the long term diet/lifestyle adjustments to make the VSG work; its' caloric malabsorption is long term vs the bypass which sees its caloric malabsorption dissipate after a year or two.. But it requires more serious commitment to supplementing and follow up lab work for life (that's part of its' "personality" that you have to live with. But I have seen many be successful over 10-20 years with it, often eating a less than "ideal" diet.

I'm talking to my surgeon about this right now as well. I've had my band for a long time and I've hit a plateau that just won't budge. You have 3 options really. Removal with no revision. Removal with revision to a sleeve (if your surgeon will do that, mine won't) and Removal with revision to bypass. I was told that going from the band to the sleeve won't have the same effect that going from nothing to the sleeve would. Because you have already reduced your intake through lap band restrictions. So the effectiveness isn't the same. The bypass would add the malabsorption to mix increasing effectiveness. Now, here's why my surgeon won't do band to sleeve revisions. With the band, you will have some scar tissue build up (unless you've only had the band for a very short while) and the cut they make for the sleeve differs from the bypass. The cut they need to make for the sleeve, passes right through where the band, and scar tissue is, so, this greatly increases the risk of leaking and in a location that's tougher to work in due to it's location being higher up in the stomach cavity. Scar tissue doesn't heal to scar tissue quite the same way that healthy tissue heals to healthy tissue. Do doctors do band to sleeve revisions. All the time. Do some people have no issues with this, sure. But... it does increase your risk, so you should be aware of that risk. I went into my follow up / revision discussion appointment, pretty much set on the sleeve. I left leaning towards the bypass. And after doing my own research, review of both procedures, factoring in the different prospective losses with each. I'm pretty sure I'm getting revised to a bypass. Just my inputs, but worth sharing.

Nancy, I think I've been kicked off more boards than Sandy. Well, I'm banned more often, that's for sure. I'm here...I'm not thrilled with my tummy tuck, but I was warned in advance that a revision was likely. So, it's a few months off. Lipo, they tell, to even things out. But they don't want to do it until everything "settles." thank you for asking. Neicy, It's never a good idea to encourage me. I'm outta control enough on my own...but thanks for letting me know that I'm not alone in my thinking on the topics at hand! Sue And I'm closer to 60 than 50...way closer. So, I think I'm gonna start saying that 60 is the new 43. ;-D

To Amy n Cocoa...a little advice from a sleever who'll revise to gbp Friday, Lord willing. Don't think of anything as"one last", bc if you do, you'll only want it more. It's not like you'll never eat it again, itll just be "one last" time that it'll be that much of it in one sitting. The mind can be an ugly thing with the tricks it can play but we are in control of those thoughts and too can play tricks back. So keep telling yourselves, it's a life style change starting with smaller amounts, not zero amounts. I hope that made sense, im on my 10 day liq preop and my mind says give it a rest:)). But gl and know that IT'S THE LAST BIG PIECE of whatever, not the last piece; ). Gl

I had a gastric sleeve revision on January 23, 2018. I have lost only 9 pound, which I lost the first week... nothing after that. I am afraid this won’t work for me again!

Hi Miami. I haven't had a sleeve revision but my weight loss was slow and frustrating after vsg surgery on 12/28/17. After surgery, I lost 7 lbs, 2nd week - o, 3rd week - +1 lb. (really! lol), and then 9 lbs. 9lbs. In 1 week! I weigh every Monday. You will have more weight loss coming. It's just going to happen when it chooses to. Stick to your path to health and you'll eventually reach your goal. It will all be more than ok. [emoji471]

Hey guys, so my mom is looking to have her lap band removed and get the sleeve like I did on the 10th. Problem is her insurance excludes the revision. We had the most horrible dr originally for our lap band 5yrs ago and were self pay, Felix Speigel. I don't want my mom going to another chop shop like him and my doctor would be wicked expensive. I've read a lot of posts referring to a Dr Aceves in Mexico. If you've used him or know someone who has would you mind telling me your story, good/bad/ugly and if you would or would not recommend going to Mexico for the revision. Any help/information would be greatly appreciated. I am afraid of losing my mom and my son to miss out of time with his Grammy.

To make your ticker and post it: http://www.tickerfactory.com/WeightLoss/weight_loss.php?type=3 1. Go to the link above and make your ticker. 2. Go to the bbCode box and right click on mouse and hit Select All then right click again and select Copy 3. Go back to LBT, click on User CP and under Settings & Options choose Edit Signature 4. Click in the signature block where you want the ticker to go, right click and select Paste You can preview your signature, or select Save to save your signature( it will look like a bunch of letters until you save it) Your new signature line will now show on all your existing posts, and all your new posts. To edit/update your ticker: 1. Click the ticker in one of your posts, or go to User CP, Edit Signature, Preview Signature and click on the ticker there. 2. The ticker page should open up. 3. Click on the Back button and revise your numbers. 4. Click on the Next button. 5. Go back to LBT and delete the existing ticker. 6. Repeat steps 2- 4.

Most surgeons aren’t doing the band anymore so it might be tough to find medical support if you need it. You may only be able to find surgeons who are willing to remove them and revise to a different WLS. RNY and VSG are the most popular by far. Ask your surgeon questions. The choice between them should be based on what’s best for you. Hopefully your surgeon can explain the factors that go into their recommendations and you choose based on research and your comfort level. I would recommend protecting yourself from information overload especially watch “experience” video or reading testimonials. Your experience will be totally your own. I also recommend If at all possible to clean and organize your space to be clutter free so your recovery is smoother (Imagine tripping on something after having surgery or needing to clean your bathroom or mop the floors immediately after surgery). Good Luck ❤️

I chose lap band first, and revised to sleeve after complications with the band. I agree with the points above about the sleeve - the only thing I'll clarify is that while there are more minor complications with the band than the sleeve, there are more risky complications with the sleeve - and more with the bypass. But really I think you should discuss options with a qualified surgeon. At 500 pounds you will have different factors that will need to be considered than someone under 3-400 would. I would strongly advise that you find a surgeon who has a lot of experience with surgery on larger patients. Apologies if this sounds insensitive! Not trying to offend. But there are increased risks of surgery with patients over 400 pounds, and the more experienced surgeons generally have fewer complications. There are also different factors to consider in terms of longterm success, so what works for others on this board may not be appropriate for you. In order to get to your goal weight you may need the malabsorption of the gastric bypass. Another possibility to perhaps discuss with a surgeon is the duodenal switch - in this approach you could start with the sleeve, and then if your weight loss slows before you've hit goal, you could add the duodenal switch, which adds a malabsorption factor, so you don't digest all the calories you eat. One of the benefits of this is that the sleeve is a shorter slightly safer surgery than the bypass or duodenal switch, so it would be a safer first surgery, and then you do the 2nd one once you've lost some weight and it can be done more safely. I wish you the best in your journey!