Rachele's Revision is Today...

[GeezerSue 7]

Hey folks,

She probably won't be here for a few days, but Rachele is having a LapBand-to-DS Revison today.

She did great with the band at first, but then had complications. She tried to make it all work, but decided that enough was enough and that it was time to move on.

For those who are not aware, the DS is the most extensive of the usually performed weight loss surgeries, but has much greater success rates than the others. (Yin and Yang and all that.) The surgery itself requires a much more experienced surgeon and there are not really many DS surgeons in the country.

When she is finished with the surgery, there is a long recovery period, with rapid initial weight loss...about 30% of excess weight is gone in the first couple of months, and by six months post-op, it's closer to 50% of excess weight loss. There are lifelong malabsorption issues and routine labs must be done and Vitamins and supplements MUST be taken religiously.

The payoff is about a 75-80% excess weight loss, maintained over five to ten years post-op (maybe longer) and a 99% cure rate for type II diabetes. More info is available here:

http://duodenalswitch.com/

Anyway, you can see Rachele's before and after LapBand photos in her profile and, if you are so inclined, I think you can send a PM or something through there as well.

Sue

[lovecats85 2]

I hope Rachele does great with this surgery and I wish her all the best. However, I do have to point out that even though the DS has such great stats as far as weight loss goes, the death rate is so high that it's not performed as wide-span as the band.

[GeezerSue 7]

I hope Rachele does great with this surgery and I wish her all the best. However, I do have to point out that even though the DS has such great stats as far as weight loss goes, the death rate is so high that it's not performed as wide-span as the band.

While I don't want to debate, I DO want to provide accurate information:

•First, some of the mortality rate of the DS is due to the fact that, in some practices, it is performed ONLY on patients with a BMI of well over 50. ANY surgery performed even PRIMARILY on those with a BMI of over 50 is going to have a higher mortality rate, because those who are super morbidly obese are dying to begin with;

•Then, you might want to factor in the band removal/failure rate. When I decided I wanted my band removed, my local "bariatric center of expertise" surgeon was about to do his FIRST band removal. In Europe--where they have had the band being put IN longer--they also have more experience taking it OUT. One surgeon I contacted told me that 20% of his surgical practice was removing LapBands. I suspect that will be the case in here a few years as well, which leads to my next point...

What percentage of people who get the LapBand will STILL die from Morbid Obesity, which--as we all know--has a higher mortality rate than ANY of the surgeries? A recent Swiss study says that 66% of band patients experience "success," which they define as 50% of EWL. In my case, losing 50% of my excess weight would leave me with a BMI of over 35, and--given my comorbidities--I'd STILL be a candidate for weight loss surgery. The early deaths of those who have the band and didn't die on the table but died later from not ever losing enough weight cannot be just ignored. Those untallied deaths need to be included in the mortality rate of the band.

•Another reason that the band--and the RnY--are performed more extensively is that they are more profitable for the surgeon and cheaper for the insurance company. I know that Dr. Rumbaut can crank out five bands on an average surgery day...and he does that twice a week. The RnY takes a little longer, but the average surgery time is getting shorter every day. The band patient is often a 23-hour stay; the RnY is a day or two. The DS patient's surgery takes two or three hours and his or her stay in hospital STARTS at three days.

Like the band and the RnY, the DS requires considerable follow-up. So...(Rachele and) I will need to be more vigilant about post-op labs, but less concerned about over-exposure to radiation. Like many banded people with problems, repeated adjustments have caused me to be exposed to FAR more radiation than I'd like to have been involved with.

I know that SOME people have had great success with the band. They have achieved a "normal BMI and are usually very gracious about it because (I suspect) they realize that they are in a fairly small group (and maybe they were just gracious to begin with.) But "success" is subjective. I've had people who were several years post-op tell me that I need to follow THEIR example...and I have been (uncharacteristically) kind enough NOT to mention to them that they are STILL obese and that the whole point of MY having surgery was to NOT BE obese. So, for post-ops who are happy that they have achieved a BMI of 37 or 42...good for them. But, for me, that is FAR from my goal.

Anyway, I cannot speak for Rachele. I know that she knows what her risks were going in. She has a baby and a husband and other family that are hoping that she is able to RESOLVE her obesity problem.

And I hope that anyone researching the band or having problems post-op will read that--according to that recent Swiss study--one-third of those being banded do not lose even 50% of their excess weight and realize that it is NOT their fault...and not be frightened by partial information and, mostly, I hope that they see that there ARE other options if their first choice does not work for them.

Good for Rachele for doing her best to win this battle.

[Sherrie 0]

Speaking of DS.. I got my first fill yesterday and as I was waiting for the doc - this gorgeous blonde woman - MAYBE a size 2 if not a 0 came frolicking in the office. She signed in and I turned to my friend and said, "Hmmm... he must do other stuff besides bariatrics!" She laughed. This woman had a flat tummy and no skin issues -

Long story short - the doc ended up telling me that she was underweight and it can be very hard to convince his DS patients to eat more :-) I said... wow - that woman used to be fat??? He said he could not discuss her - you know HIPPA... but he only does DS on people with BMIs over 60.

He also did admit to doing her Tummy Tuck. No kidding.

[Vera 7]

Wishing the best for Rachele!

Glad to see you around Sue and was wondering when is your conversion? I'm speculating soon...

I have a niece who's been talking RNY and Im trying to open her mind and feeding as much info to the DS. I know after reading all your attachments if I were headed in that direction it would be the DS for me.

Thanks and take care Sue.

[Alexandra 55]

The early deaths of those who have the band and didn't die on the table but died later from not ever losing enough weight cannot be just ignored. Those untallied deaths need to be included in the mortality rate of the band.

Sorry, I don't agree with this. Treatments that "fail" are not considered treatments that "kill."

[lovecats85 2]

Every surgery has goods and bads, every surgery has risks and benefits, every surgey has people for it or against it.

Stats taken from medicine journal articles will allow us so specifically compare the band and the DS.

Banded people statistically lose 50% of excess weight. DS statistically lose 60% of excess weight.

Band surgey is restrictive only. The DS is malabsorptive surgery which may improve results and reduce lipid levels, but risks nutritional deficits.

DS risks:

Listing of complications of DS:

• Protein Malnutrition 15%
  
• Incisional hernia 10%
  
• Intestinal obstruction 1%
  
• Acute biliopancreatic limb obstruction
  
• Stomal Ulcer 3.0%
  

Bone Demineralization:

• Pre-op 25%; at 1-2 yrs, 29%; at 3-5 yrs 53%; at 6-10 yrs 14%.
  

Benefit - no dumping sydrome like GB.

Anyways, point is, noone is ever going to find 100% accurate asnwers and the statistics are all varied. There is not a 100% accurate reporting method for all doctors all across the globe so since 98% of people on this site have chosen the band, let's not scare them with stats like 20% of bands get removed when that may or may not be true. And I won't talk anymore about the death rates I've heard for DS b/c they may or may not be true and I don't want to scare the DS people.

[GeezerSue 7]

Sorry, I don't agree with this. Treatments that "fail" are not considered treatments that "kill."

You have the right to disagree. But if you have a surgery that is supposed to correct a problem and it doesn't and you die from the uncorrected problem...

[lovecats85 2]

But then why should those stats be included in the band but not GB or DS? No WLS has a 100% sucess rate - DS says people will lose 60% of excess weight (and this number will likely decrese the more it is performed as with every WLS) so if a 50% loss of excess weight would leave you with a BMI or 35, then 60% excess loss will leave you with not much less of a BMi, right?

[mousecrazy 2]

Since this is a lapband board, of course, most of us have made a decision to have Lapband over DS...and of course, most of us are committed to the decision we have made. If someone else makes a different decision, whatever the reason, they have made that decision based on the best info they have available, taken into consideration along with their own physical health issues. There is no need for a battle, unless is it purely academic/medical, and people enjoy the lively debate. If it is personal, it's best to excuse ourselves. I wish Rachele the best, and a quick and safe recovery. Cindy

[GeezerSue 7]

Since this is a lapband board, of course, most of us have made a decision to have Lapband over DS...and of course, most of us are committed to the decision we have made. If someone else makes a different decision, whatever the reason, they have made that decision based on the best info they have available, taken into consideration along with their own physical health issues. There is no need for a battle, unless is it purely academic/medical, and people enjoy the lively debate. If it is personal, it's best to excuse ourselves. I wish Rachele the best, and a quick and safe recovery. Cindy

Does that mean someone is taking this "lively debate" personally? I know what the purpose of the board is...I was there online the day Alex offered to furnish us with the board. But thanks for your input.

[GeezerSue 7]

...

Stats taken from medicine journal articles will allow us so specifically compare the band and the DS.

Citing sources would be helpful.

Banded people statistically lose 50% of excess weight. DS statistically lose 60% of excess weight.

The actual number is closer to 75% after many years. http://win.niddk.nih.gov/publications/gastric.htm

Band surgey is restrictive only. The DS is malabsorptive surgery which may improve results and reduce lipid levels, but risks nutritional deficits.

The band has its own malnutrition issues...but for different reasons. DS'ers eat and still have nutritional deficits...Banded people can't always eat enough. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=12527349&query_hl=16

...

Anyways, point is, noone is ever going to find 100% accurate asnwers and the statistics are all varied. There is not a 100% accurate reporting method for all doctors all across the globe so since 98% of people on this site have chosen the band, let's not scare them with stats like 20% of bands get removed when that may or may not be true.

Since I got that information from the manufacturer of the band, Inamed, www.lapband.com

it's probably fairly accurate. Of course there are practices with FAR better results, but this is apparently the best Inamed can tell us right now.

And I won't talk anymore about the death rates I've heard for DS b/c they may or may not be true and I don't want to scare the DS people.

There is no single source for the DS surgery mortality rate...but it is generally accepted to be around 2%. The RnY is around 1% and the band is about .01%, last I checked.

My point--and I really wanted this to be about Rachele, but I'm always up for citing sources...that damned college debate team I guess--was that even though this is a band support site, some of us who were banded--a long time ago--have done our best and have decided it is time to move on.

We can just disappear, so as not to burst anyone's bubble...or show some courage in continuing to OPENLY fight the demon we all share. Many of us got the band because we did not want RnY. If/when the band fails, it is nice to know that there are other options.

Remember, one of the selling points of the band is that it can be removed. Do we want people to slink off and do that silently...or are we up to hearing how that works out?

I'm not telling anyone not to get a band. But I want to tell the truth about what life is like when it doesn't work.

[GeezerSue 7]

But then why should those stats be included in the band but not GB or DS? No WLS has a 100% sucess rate - DS says people will lose 60% of excess weight (and this number will likely decrese the more it is performed as with every WLS) so if a 50% loss of excess weight would leave you with a BMI or 35, then 60% excess loss will leave you with not much less of a BMi, right?

Good point...if the DS had only a 60% average ewl rate, I wouldn't be going through surgery again. I realize that I MAY have only a 60% ewl...it happens. But the average is about 85% with a rebound to about 75%. (I'm still not sure where you are getting the 60%...I have not seen that number in relation to DS.)

[Kelliebelly 13]

Hi Sue

I wish Rachele the best of luck. I was wondering how much did you guys lose with the band? Did you have troubles finding restriction? Im hoping I am not asking too many personal questions I was just wondering what the reason was the band didnt work for either of you.

I agree letting people know the possibilities of what could happen with the band, even though I read all the stories when I was researching and the small amount of complications was not enough for me not to give it a try.

Good Luck to both of you

[lovecats85 2]

well, I can't argue with your stats over mine or vice versa - you read one set of stats and I read another. I'm no expert - I can't tell you which stats are "right". All I do know is no surgery is fool proof and every surgery has risks and benefits. As far as my own personal thoughts - I chose the band and I am going to stand up for my choice and choose to believe the "better" stats,,, and if I had chosed DS I would stand up for that and choose to believe the "better stats". I know if my band didn't work and I was having DS I would try to sell myself on whatever stats made me feel better and I would tell myself it was a problem with the band and not me. Let's be honest here - we'd all do the same so I can't blame anyone who is switching to DS to want to beleive ALL the good stats about DS and ALL the bad stats about LB when in reality LB and DS and GB ALL have risks and benefits.