Am I a good candidate for Band to Sleeve Revision?

[VSG Tommy B 10]

Hi everyone,

I haven't spoken to my doctor about this yet because I want to have as much information as possible before bringing it up with him.

HISTORY:

I had a standard lapband implanted in March 2011. At the start of the band process I was 315 lbs and on surgery day I was 276 lbs. I am 6'0" and currently weigh 255 lbs (BMI=34). My lowest weight was 236 lbs a little over a year ago before adopting a baby and buying a business. I got back up to 265 lbs because of the stress of those events (now back into a regular routine of eating the right foods and exercising regularly) plus my doctor removed a lot of the saline from my band because he said I have esophageal dysmotility and an inflamed esophagus due to reflux but I never feel acid indigestion. I just feel inflammation of the esophagus and often feel a lump in my throat. I have been taking nexium or omeprazole 20mg twice a day and the inflammation is a little bit better and the lump gone. My port site is frequently sore like I pulled a muscle and protrudes so much it is visible if I wear a tight shirt and you know what to look for.

I recently had an endoscopy and was told that the lapband is fine. There is no slippage, erosion, ulcer or other problem with the band. The doctor took biopsies of the esophagus because of the inflammation. I see the GI doctor on Friday for the biopsy results which I predict will only be caused by acid reflux.

The lapband doctor recently (after the endoscopy) added .5 cc to the band (now at 3.5 cc total) because I was able to eat WAY too much without getting full. I can now regularly eat a 12oz prime rib, veggies, salad, some bread and dessert (which is less than before the fill). I also have many days (now and before the fill) when I can't eat 2-3 bites of moist meat without throwing up. A lot of times I throw up (sometimes with the right foods, other times with fiberous foods, bread, Peanut Butter etc) but am still hungry. My doctor is very reluctant to add more Fluid to the band because he thinks it will further aggravate the esophageal dysmotility and inflammation. Although I hate the problems of not being able to eat certain foods that clog the band and make me vomit, I could live with it if I can get more restriction. If I can't get more restriction, I will not lose any more weight and fear I will regain even more weight. I am doing the initial research to determine if the gastric sleeve would be a good choice for me.

QUESTIONS:

1. Can I get a sleeve with the esophageal dysmotility and inflammation?
   
   
2. Can I qualify for the sleeve (self-pay) with a BMI under 35?
   
   
3. My insurance will cover medically necessary band removal, but not weight loss surgery. Any suggestions for getting at least some insurance coverage?
   
   
4. Is the feeling of fullness with a sleeve really different than the feeling of the band pouch being full?
   
   
5. Can I go back to eating some of the foods (in small quantities) that I can't eat all now without clogging the band?
   
   
6. Any suggestions for surgeons in Raleigh, NC in case I decide to switch surgeons?
   
   
7. Anything else I need to know? Any other thoughts?
   

​Thank you all very much.

Tom

[VSG Tommy B 10]

I forgot a couple of questions:

1. Can a revision be done with the scarless incision process?
   
2. From the time I decide to get the revision, what are the steps required? Do I need to do all the tests I did before the band? Do I need another psych eval? Another visit with the nutritionist? Any other hoops to jump through?
   

Thanks again,

Tom

[PEvette 297]

• Can I get a sleeve with the esophageal dysmotility and inflammation?
  
  I too had an inflammed esophagas, the band had caused me to develop it as well as mild acid reflux....so I would ask your doctor could the band be the cause of your problems and would removing it clear it up for you....it did for me, haven't had acid reflux since revision..
  
• 
  
• Can I qualify for the sleeve (self-pay) with a BMI under 35?
  
• Honestly with self-pay, you can get pretty much what you want. I was self-pay for both lapband and my revision...the BMI requirements come in when you are doing it through insurance or if your doctor has personal preferences....I know some people through my support groups who had revision to VSG and they were like 30 pounds from their goal weight with the lapband...
  
• My insurance will cover medically necessary band removal, but not weight loss surgery. Any suggestions for getting at least some insurance coverage?
  
• Since you are lucky to have band removal covered by your insurance I would suggest letting them pay for the removal, wait 6 weeks then let the doctor to the VSG....so you dont have issues with medical coding....
  
• Is the feeling of fullness with a sleeve really different than the feeling of the band pouch being full?
  
• IT IS SO SO DIFFERENT! Sorry for the all caps but it really is different....with the band you could easily over eat just by eating and drinking at the same time....with the sleeve, you physically cant! You are full, I call it Fat full, as in if I eat another bite I will get sick...its just like getting super stuffed with your whole stomach..
  
• Can I go back to eating some of the foods (in small quantities) that I can't eat all now without clogging the band?
  
• Yes you can...with the band I could rarely eat salads, and could not eat broccoli and apples at all...with the sleeve I dont have to worry about clogging or sliming when I eat food....
  
• But with that said, some people are different, I know some people who after revision just cant eat beef anymore, just too heavy on the stomach for them....me, I can tolerate everything with my charlie (mysleeve) just cant eat as much of it as before..
  
• 
  
• Any suggestions for surgeons in Raleigh, NC in case I decide to switch surgeons?
  
• SOrry I cant offer suggestions for surgeons there, as I live in Texas, but when you are looking for a revision surgeon, research the number of revisions they have done, whether they were done lap or open (that was a biggie for me) and their complication rate...try to find a doctor who is confident and comfortable with doing revisions....I was self pay and I understood the complications involved, and my doctor was AWESOME, he was confident, literally held my hand through the whole process, I had total faith in God to work through him to allow me to have a complication-free surgery...and I still praise God for leading me to him....I love my doc! Sorry went off topic...lol
  
• Anything else I need to know? Any other thoughts?
  
• 
  
• The only other thing I can add is that getting revision saved my life....I started with the lapband at 320 pounds, lost 40 pounds in 6 months and maintained it for a couple of months then gained it back and got up to 339...when I went to see my revision surgoen I was at the end of my rope....I'd developed high blood pressure, pre-diabetes, had 2 knee surgeries, and my back was killing me at 339...and to top it off I had a freaking lapband on my stomach, I was embarassed to tell people I'd had lapband surgery....and like I said, he walked me through it all...
  
• 
  
• I hope I was able to help you out by answering your questions, I remember going through this I was all over the place and this site really helped me realize that I wasnt alone...when I see others come on here seeking direction, I like to pay it forward....
  

[Threetimesacharm 1,400]

I am not sure if I can answer any of your questions but here is a little bit about my situation:

I had the lapband for 5 years

Could not eat yogurt, fruit, beef, raw veggies, many cooked veggies, sometimes chicken sometimes not, same with fish.

lost 60 pounds and did keep it off for the 5 years

realized that I really couldn't keep the band in my body for ever even though I had adjusted my lifestyle to it: eating slider foods, eating more at night

found this website and 6 weeks later I had the revision

Now I was self pay and decided to go to Mexico. Do some research. You will find that Mexican surgeons are way more experienced than those in the U.S. and take many precautions(three leak tests). The price is very reasonable and my surgeon Dr Garcia was an amazingly skilled surgeon.

I will tell you know that it was the best thing that I could have done for myself. I am now 14 pounds form goal(16 weeks out) and feel like a new person. You will not regret going for a revision. It also was done in one surgery so I did not have to endure two of them. Please PM me if you require any further information.

Best of Luck

Happy New Year!

[VSG Tommy B 10]

Thank you both very much. I appreciate you taking the time to respond.