re banding after eroded

[Alexandra 55]

...any complication requiring REMOVAL of the band would warrant conversion to another bariatric operation, since weight regain is guaranteed after removal of the band (or reversal of any bariatric operation, for that matter).

Mark Pleatman MD

First, I'm wondering if the medical community at large agrees that removal of the band warrants conversion to another bariatric operation at any time. What if the person is at goal weight? Wouldn't any doctor (and insurer) wait to see if the patient regains a significant amount of weight before doing another operation?

And second, I have to echo DeLarla's objection to the "weight regain is guaranteed after removal" item. I hear doctors say that all the time, and it's just so demeaning to us as people. First we're told we have to change our lifestyles because the tool doesn't do it all, and then we're told that the doctors don't actually believe we CAN change our lifestyles enough to maintain the lost weight without the tool.

OF COURSE we all know the band helps, and of course we as lifelong dieters know that without it maintaining the loss will be harder. But it's not helpful to be told that it's impossible and we should give up before we start.

[La_madam 20]

since weight regain is guaranteed after removal of the band

Dr. Pleatman Does every patient regain their weight? I had my band removed on November 28th 2005 from erosion...I have yet to gain ANY weight back yet...when does this happen? How long after the band is removed will weight gain occur? I would like to think I did learn something from my band journey which is helping me to not gain the 100+ lbs I lost in 18 months with my band.

[sunsett 2]

I appreciate your input Dr. Pleatman.

La Madam, I'm sure if anyone keeps to the band rules, they would lose. or mintain. Hang in there keep up the good work and try not to let others influence your success.

It is ashame that some people feel that they have to attack, at least thats how it looks to me.

[AliDiane 0]

Dr. Pleatman,

If you are not advertising for business, then please explain what motivates you to post on LBT so frequently and with such strong opinions. It puzzles me that you would spend so much time and energy posting on a LB support group forum. I would appreciate hearing your explanation.

[GeezerSue 7]

Dr. Pleatman,

If you are not advertising for business, then please explain what motivates you to post on LBT so frequently and with such strong opinions. It puzzles me that you would spend so much time and energy posting on a LB support group forum. I would appreciate hearing your explanation.

Pleatman can explain for himself...but Trace Curry, M.D. regularly posts on the OH LapBand board, too.

I just think we're lucky to have them and ought to be delighted to hear INFORMED opinions, since there are so many of the other kind floating around. Well...I wish they were both a little more receptive to the DS, but...

[DrPleatman 3]

Dody:

I agree with much of what you say, but I also disagree with some. Remember that I do Lapbands. I agree that a 64-year-old with a history of cardiac bypass surgery would be a good candidate for Lapband; in fact, I might refuse to do a bypass on such a patient.

Dody; you've misinterpreted what I've said in implying that I recommend bypass for everyone. The main thing I've said that has pissed people off here is this: People who have serious band complications ought to consider having a bypass. That's all. I have plenty of happy band patients. The band is a great tool. I recommend it frequently.

You say that Vanderbilt recommends Lapband as procedure of choice for all patients. This is not true. In fact, if you look at their web site you will see that most of what they do is gastric bypass. The surgeon pictured on their site, Bill Richards, does only gastric bypass. Get your facts straight.

Center of Excellence... mostly politics and BS designed to limit access to surgery and save money for the Medicare system. There is very little data to suggest that good care cannot be rendered in small centers; that being said, we've paid the big bucks they demand (more than $10,000) to get designated as a Center of Excellence, and will soon have the designation.

Finally, you say,

'but I also don't believe a failed gastric bypass patient should be allowed to convert to lap banding if they fail down the road at gastric bypass. Apples and oranges...I don't think so!!'

What the hell are you talking about? Banding after bypass IS done on certain occasions. You should preface all your remarks with the disclaimer, "I'm not a doctor and I don't know what I'm talking about."

Cheers

Mark Pleatman MD

[StrawartS 2]

Dody,

Regarding your comment about Mexican doctors operating on anyone...I have no experience with Mexico, but I wouldn't be that generous to American docs. I didn't have to do ANYTHING to have my surgery. No sleep study, no nutritionist, just a chest x-ray and and blood work. My mom and I were both banded by the same doctor, and he laid eyes on her for the first time LITERALLY when she was being wheeled into the OR. He only met me the day before my surgery because I scared his office staff with the story about my mom.

Anyway, my comment is irrelevant to this discussion, but I always like to point out that when it comes to a quick and easy self-pay patient (or two), American doctors are no less greedy than Mexican ones.

[NewSho 20]

Alright, so what's wrong with a surgeon expressing his opinion on what they've seen in their patients after LapBanding?

The main thing I've said that has pissed people off here is this: People who have serious band complications ought to consider having a bypass.

Raising my hand here... Been there, done that, got the hospital gown. I've previously had major complications after LapBanding. I've recovered (knock wood) and I'm still banded, but after going through what I've been through with the band, a revision to a bypass procedure, doesn't quite seem as drastic as it seemed before I was banded. So my fellow banded patients who "pooh pooh" the idea of a revision to a bypass surgery, probably haven't quite had to face what some of us who've had complications have faced. And yes, people on LapBand forums do NOT like hearing this....but walk a mile in my stiletto shoes and still end up at the weight I'm at now. Suddenly a bypass isn't quite so scary...it isn't what you might want, but as an alternative to more LapBand drama, then bypass starts looking OK.

Leatha:

50% weight loss is considered to be success, so that alone would not be an indication for conversion; but any complication requiring REMOVAL of the band would warrant conversion to another bariatric operation, since weight regain is guaranteed after removal of the band (or reversal of any bariatric operation, for that matter).

Mark Pleatman MD

I suspect my original surgeon feels the same way as Dr. Pleatman about band success - but the only difference is that I think my surgeon thinks it's OK for me to be obese forever since I'm "not that big", rather than considering that the bypass could potentially be the next step in helping me getting the rest of the weight off, and to keeping the weight off over the long term.

That does make me angry because at my current weight and BMI - if I'd had the RnY bypass no surgeon would have called this a success. It's hardly a reflection of the amount of time, effort and money I've put into my weight loss journey. But with the band - it's "oh well, good luck, you only get 45% to 50% of your weight loss - so deal with it." And all banded patients should be aware that no matter how hard they may work, they might not be in the minority that successfully loses a large portion of their excess weight. And after some suffering complications too, why not consider bypass?

I'm working with the band now and hopefully it will help me get to where I need to go, but if it doesn't work (and if I suffer further band-related complications) I will consider next steps.

So everyone's different. And if there are those who are more willing to accept the band's limitations and are pleased with what they've lost: great. If I hadn't been through what I'd been through, maybe I would be more accepting too, but after dealing with all of this AND still being overweight/obese/fat ??? No way, this sucks.

___________

have personally left out the Mexican doctors in this thread because they will operate on anyone that shows up with money and do any surgery.

Like it or not you that went to Mexico know you didn't need sleep studies or any of the requirements in the states for your surgery. Perhaps that is why without an upper GI a lot of you suffered esophageal problems.

How can you even say this? I know US docs who don't require extensive tests, especially for their cash patients.

And to insinuate that those of us who have had complications had them because we aren't getting tested is utter crap. I have had Upper GI's (had one 2 weeks ago) and every other diagnostic test relating even remotely to LapBanding. Yet my post-LapBand medical records read like a soap opera script, if not more dramatic.

I wouldn't be banded in Mexico on someone else's dime. They have a huge erosion rate and they don't even require a diet beforehand to shrink the liver.

Neither do many US docs require a pre-op diet for liver purposes. Lower BMI patients with minimal signs of enlarged livers are routinely exempted from pre-op diets. I was - and others I know also were not required to do special diets specifically for liver shrinkage.

It has to make you wonder if that may not be one reason for erosion...the liver is too big to get the band high enough on the stomach.

Your knowledge of Band Anatomy could use a bit more research. It's just not true.

I think there are lots more erosions from Mexico because the surgery is but a plane ride and a walk in the part for $10,000. That's just my 2 cents for what it is worth.

You said it.

I would rather jump (or step gingerly) through the hoops to have an excellent surgeon in the U.S.

I prefer US doctors too, just because the logistics of maintaining long term relationships with out-of-the-country surgeons is too difficult for most patients. I can name a specific Mexican hospital facility that I do not recommend due to the long history of complications at this particular location. But other Mexican facilites are first-rate. But just being in the US doesn't mean a surgeon is excellent, by any means.

But your across the board comments about US surgeons being better are quite unfounded.

Happy Band (and UnBanded) Journeys to all...

[GeezerSue 7]

NewSho,

Well, then...BRAVO!

[GeezerSue 7]

StrawartS...I just like palindromes.

[desertmom 297]

hi

Dr. I like the fact that you are on the forum.

I really dislike this band.And I deeply regret I got onto the internet that convinced me that the band is safer and easier to do than the other operations.

If there was forums like this one....for complications.....before I had the operation and people speaking out about it I never would have considered it....(I got so scared of the "higher mortality rate" of the other ops)

And I am one of the people that will honestly say that if this band is removed and I dont diet everyday of my life I will regain this weight in a flash......

After battling the issues I've had,the other operations really lost their fear factor for me too.

Not that I'm going to do another one.After this one is gone I need to be back in a life without this constant issues.....diet and exercise sounds very acceptable to me now...

I

[tracey anderson 0]

Hi,

I just want to thank everyone for there replys. Dr. Pleatman how about we make a deal for a really cheap GB. I thank GOD my insurance is paying for my removal it cost well over 40,000.00 to have the band removed. I have a copay and a 2000.00 out of pocket that I have to pay but other wise they are covering the rest. Now for GB they do not cover it at all. I tried that before I had the band placed. So what due you say Dr. Pleatman FREE. Thank you for your time. Tracey Anderson

[fabfatgrl 10]

I have personally left out the Mexican doctors in this thread because they will operate on anyone that shows up with money and do any surgery. Like it or not you that went to Mexico know you didn't need sleep studies or any of the requirements in the states for your surgery. Perhaps that is why without an upper GI a lot of you suffered esophageal problems. I wouldn't be banded in Mexico on someone else's dime. They have a huge erosion rate and they don't even require a diet beforehand to shrink the liver. It has to make you wonder if that may not be one reason for erosion...the liver is too big to get the band high enough on the stomach. I think there are lots more erosions from Mexico because the surgery is but a plane ride and a walk in the part for $10,000. That's just my 2 cents for what it is worth. I would rather jump (or step gingerly) through the hoops to have an excellent surgeon in the U.S.

Dody:

This is completely biased and inaccurate. I went to Mexico before the Band was even FDA approved. I did not need a sleep study (nor would I have needed one here with the surgeons I know)... but I did need a slew of other pre-op tests. Also, my surgeon Dr. Rumbaut does not have a high erosion rate at all. He is, in fact, one of the most respected Band surgeons in the world. Period.

Also, you mention having an excellent surgeon in the U.S. Well, at the time, Dr. Rumbaut had done over 2500 bands. The average U.S. surgeon, if he was a FDA trial doc, had done maybe 50. 100 max. Which would you choose??

Are there unscrupulous Mexican docs?? Sure. But there are unscrupulous US docs as well. Don't be so naive. US does not always equal best.

Karla