Flip a Coin?

[Elisabethsew 50]

I've been reading posts on this board for about 2 months now and am a little concerned that some people seem to feel that complications from the lapband are minimal and that RNY and DS gastric surgeries are a sure Rx for complications.

Because of pre-existing health conditions, I made the decision to have lapband surgery as well as to have the surgery done here in the United States. While it is true that lapband surgery is less involved and less invasive than other forms of gastric surgery, post-op complications do arise.

I've been an RN for MANY years and I train RNs to work in ICUs. The hospital I work in has a very big bariatric surgical program. Currently, we have a patient in the surgical ICU who opted to have lapband surgery. This patient is 43, male, a lawyer, 320 pounds, 5' 10" with no co-morbidities. He wanted to surprise his wife so he told her he had a business trip to take and went into the hospital on Friday to have his surgery. He stayed overnight and went home on Saturday.

On Monday, he was feeling "weak" and spiked a fever to 100.5 and went to the ER. He was placed on an antibiotic and sent home. Two days later, he was short of breath and his fever was 101.4 so he went back to the ER. While there, his shortness of breath worsened and he was placed on a ventilator and transferred to the surgical ICU.

The patient was diagnosed with sepsis (overwhelming blood infection) and, during the course of his 4 weeks in the ICU, he cardiac arrested twice, went to the OR to be unbanded, returned to the OR 5 times for a gastric "wash-outs," developed renal failure, was placed on dialysis, was trached (tube into the trachea) for prolonged ventilator dependency and required nutritional and physical therapy support.

The patient eventually got off the ventilator and was transferred to the floor. He will always have renal insufficiency and will need months of physical therapy but he is expected to make a "full" recovery.

My point in sharing the experience of this patient is to illustrate that ALL surgeries have risk factors. It's important to talk with your MD and research ALL available surgeries. I have seen 60 year old patients with one or more co-morbidities sail through RNY surgery while a 30 year old healthy patient having the same surgery ends up with complications in the surgical ICU.

Price should NEVER be the deciding factor when choosing a surgeon or a facility. Likewise, one should NEVER decide on one gastric surgery over another until ALL are options are researched and the pros and cons of each are addressed. My surgeon drilled me on my dietary intake. Why? He wanted to determine if I was a junk food lover or a volume eater. Why? Because if I was a junk fook lover, he would have suggested RNY for me explaining that it's easy to "cheat the band or beat the band" by consuming empty, high carb foods that easily slip through the band.

So, take the time to make the RIGHT decision for YOU and CHOOSE wisely.

[leatha_g 4]

Very good advice, Elisabeth. Thank you for the reminder that this or any other surgery is definitely a major thing.

[3loves 0]

You make an excellent point and I agree. WLS is an elective surgery and shouldn't be taken lightly. I think some people overlook the fact that death is a real possibility....in any surgery for that matter. One needs to be smart about it and do research. In addition, I prayed and had total peace. I realize some don't do that, but personally, I couldn't face tomorrow without the Lord. :angel:

I disagree to a certain point on the RNY/band thing. Some of what you said is true however, some people cheat the RNY too and there are many that gain weight back with the band and RNY. It seems to be my motto lately (hey, I think I'll put it in my signature line) that addiction is managed, not cured. I heard Dr. Phil say that & it hit me like a ton of bricks. Regardless if what type of surgery you have, you still need to manage the food put in your mouth.

[shackdog 1]

Thanks for sharing this should help many make the decision that is best for them. The point being, do the research............................

[sisterfunkhaus 3]

The fact is that WAY fewer complications arise from the lap band. Period. The nation wide surgical group that my surgery center belongs to has NEVER had one serious complications out of THOUSANDS of surgeries.

I don't understand why people feel the need to come put us lap bandsters in our place. What do you get out of it???? :confused:What's the pay off? Why do you feel the need to treat us all like children and "tell us how things really are" ?? We aren't stupid little children. Most of us have done our research and know exactly what we have gotten ourselves into.

[Elisabethsew 50]

The fact is that WAY fewer complications arise from the lap band. Period. The nation wide surgical group that my surgery center belongs to has NEVER had one serious complications out of THOUSANDS of surgeries.

I don't understand why people feel the need to come put us lap bandsters in our place. What do you get out of it???? :confused:What's the pay off? Why do you feel the need to treat us all like children and "tell us how things really are" ?? We aren't stupid little children. Most of us have done our research and know exactly what we have gotten ourselves into.

I'm very sorry that you took offense to my post. I noticed a LOT of new people here and MANY were asking for advice. I myself chose lapband surgery and that was after I investigated all the options available to me. My point was that new people or people who are coming to this board as a "first stop" in their research process need to ask MANY questions and decide on the surgery that is right for THEM.

I care for bariatric patients on a full time basis and have 25+ years working in the healthcare profession. I'm sorry your so defiensive and objected to me expressing my point of view.

Have a nice day.

[rachele 0]

Elisabeth, Thank you for the well spoken, educated post. So often people forget that, yes it is the safest, but surgery is surgery.

I've had the band and the DS, both lap, and recovery was fast and easy (edited to add FOR BOTH). I'm lucky!

[3loves 0]

Hi sisterfunkhaus ~ Just read your update on the May thread....glad to hear your doing well...me too!! We were banded the same day. :biggrin1:

This post was meant to be helpful and not condescending to lap band patients. I know you've been here for awhile, but have you ever been surprised at some of the questions people ask? Even AFTER their band? Some people don't even know what to eat. :cry I have read where someone was shocked to find out that death was a complication.....WHAT.....they didn't know that? :confused: I know you've done your research and so have I, but maybe this thread will help just one person. It is full of truths and I found the tone to be very friendly. I hope you reconsider the tone and realize it wasn't meant to offend.

Take care and I look forward to sharing your journey!!!

[Alexandra 55]

Elizabethsew, thanks for the sobering reminder that ANY surgery is not to be undertaken lightly. Do you have any knowledge to share as to why this person GOT sepsis in the first place?

While there IS a complication rate with banding--as there is with any surgery right up through wart removal--there's no question it's MUCH lower for banding than more invasive surgeries. That's a simple fact, true. However, we shouldn't pretend that surgery is a walk in the park, even if it feels that way to some people. It's a big deal, no matter what.

[Elisabethsew 50]

Hi Alex,

The surgeon who did the procedure has done approximately 1500 procedures and no etiology (reason) could be found as to why this patient developed sepsis. It was speculated that he might have been ill before the surgery but the patient does not remember feeling sick.

With any patient who develops sepsis and has to go back to the OR (regardless of type of surgery), the surgeons elect to do an open procedure and leave the incision open with a clear dressing called biofilm. Anytime the patient spikes a white blood cell count with a shift or becomes febrile, they take the patient back to the OR for a sterile "wash-out" of the abdomen.

The complication rate of RNY patients is greater than banded patients where I work and it was quite surprising to me that this otherwise healthy man nearly lost his life several times.

[gentlespirit 1]

Elizabeth~

Thank you for what I thought was a well thought out and timely post. I've also noticed a lot of new people here and some seem to think this is just a piece of cake. Don't we wish it were that easy! I think it's important to remind all of us that any surgery always carries an inherent risk. I think we forget that even with the excellent medical care available, things DO happen. I appreciate your voice of experience from both sides of the question...banded and caring for bariatric surgery patients.

Emily

[fishy 0]

I get the feeling that there is an increased interest in the band and other forms of bariatric surgery, mostly due to the increase of obesity awareness this country seems to be going through. I'm seeing advertising by doctors in newspapers, magazines and TV for the lap band, etc. that I've never seen before.

I think that it is more important than ever to thoroughly research before choosing a surgeon, becauses anytime there's a trend, there are businessmen and charlatans alike who are wanting to cash in on it. So there will be more surgeons popping out of the woodwork, and more horror stories in the near future.

A forum like this has an incredible amount of information, most of which is based on real-life experiences and is therefore extremely valuable - however, IMO, this SHOULD NOT be the only stop on the research road. books, physicians, nutritionists, the Internet, articles written by experts in the field, the library, bariatric patients, support groups, etc. - all should be used before making one of the most important decisions you'll ever make.

[Marimaru 7]

Thank you for that great post!

I think that lots of people see "less invasive" to equal "not major surgery" and that's just not the case. Any time you are under anesthesia is "Major" even if the procedure isn't much of anything.

I myself bounced back quickly after surgery, and was running errands less than a week after, and then got tired all of a sudden and had to remind myself that it was major surgery and that even if I felt "fine" I needed to take it easy.

[Tricia K. 0]

Great post! Thanks, Elizabeth.

Alexandra - this thread reminds me of a not-so-recent thread of mine. I'm wondering if I should bump it now.

[Elisabethsew 50]

Thank you all for the nice comments. The majority of our bariatric patients do quite well with the surgery but, as Sarah pointed out, general anesthesia and obesity are not something to be taken lightly. It's impossible to predict who will have complications or why a seemingly healthy patient does worse than one with co-morbidities.