I'm so confused and scared

[hnkids3 0]

My physician recommended me for the lapband after struggling with obesity since I was young, and the affects my weight is having on my arthritis in my hips and back. I went to the first class tonight to start the process, and the Dr who held the class began talking about how the sleeve has taken the place of lap band in my area.. I'm scared I won't qualify now . My bmi is 37. They kept talking about the risks, and problems you have to have with a bmi under 40 to be able to qualify. I don't have those (yet) although I have arthritis in my hips, shoulders , back , arms and hands, according to my Dr my weight is making my symptoms worse. I'm absolutely miserable, with my weight and no self esteem or confidence. I need and want this surgery to help me, and to be able to live a long healthy life for my children. But now knowing that lap band that I've done so much research on n had it instilled in my head that I could get is no longer available, I'm petrified. I'm so scared to get some of my stomach removed. (Know people who've had bad experience) ... Please tell me the benefits, the risks, the positives over the cons.. lay it out for me please someone!!! I know nothing about this type of procedure. ( sorry for the book I just wrote)

[hnkids3 0]

O forgot.. I'm also still nursing my 7 month old, I know n had a plan for the lapband to continue nursing.. I'm just at a lost. What's the recovery time of the sleeve? Do u fast for tbs sleeve pre op?

[kristikay 60]

I did a lot of research on the lap band also and when I had my first appointment with my surgeon he said that they really were not recommending the band anymore but if I wanted it he would do it. Since then I have only been hearing negative things about the lapband and have decided to go with the gastric sleeve. With insurance I don't think the requirements are different with the sleeve than the lapband. Are you self pay and is that why you want the lap band because it's cheaper? From what I now know I would never have the lapband. A lot of people that had them did not lose the weight or had complications and had to have it removed. This is seems much safer, no foreign object in your body and no having to get adjustments by injecting saline into the port. Once you research the sleeve I think you will get more comfortable with it. I choose it over the gastric bypass because it seems much simpler and does not move your intestines and you do not have the malabsorption issues.

[Shergirl 18]

I can relate. Orginally I was looking at the lapband and was told by local Dr.s that I need to have a higher BMI or 2 comorbidities ( other physical issues) which I don't. Then I started researching lapband in Mexico and then found I had other options. After research into lapband, plication and sleeve, I decided that sleeve is the best option for me. I am going to Mexico because of cost and I don't want to wait until I actually have enough physical issues to have surgery in the states.

There is lots of good information on the internet. Check out youtube for videos about the different weight loss procedures and good luck with your decision.

[PdxMan 4,292]

Hello and welcome to VST.

After reading your post, my first thought was ... you have researched the band and are convinced that is the best bariatric surgery for you? Really? I, too, started my research thinking lap band as I didn't want to have things re-routed (RNY) or stomach removed. But as I researched the band, I learned that would have been a disasterous choice for me. All the stories about slipping and having to constantly go in for adjustments. Needing adjustments because I would have been throwing up, having reflux or the other extreme, not losing weight because the size was too large. Then to top it all off, the band scars and damages the stomach. Permanently. How was I going to fix that?

Bypass (RNY) wasn't ever a choice as I did not want my intestines re-routed. God laid them out the way he wanted. I wasn't going to argue that point with him. Also, the pyloric valve doesn't operate naturally, either. Yes, it passes stomach excretions through, but that doesn't help the body decide when to pass food into the intestines. Malabsorption issues for the rest of my life ... no thank you. Bowel obstructions ... not for me. Pouch stretched back to large enough size so I gain most if not all the weight back ... well, I think you get my point.

So, I researched the sleeve. In it's most basic form, all that is being done is making my stomach smaller by taking the stretchy part of the stomach out. I could argue this point with God. "Hey, love the stomach, but I am having issues with the amount of food I am eating, so I'm just going to make it a bit smaller ... well, maybe more than just a bit." But it works for me. That is all that happened. Take the existing stomach and make it smaller. Leave all the plumbing in the right place and have everything functional. Sounds perfect, eh? For me, it is. I can eat anything and everything, just in smaller portions.

Pre-sleeve, my thing was feeling full. I love feeling full. I always ate until I was FULL. You know what? Same is true today, I just get full a whole heck of a lot faster. I go out to dinner with my wife and we split a meal. And take home leftovers.

Recovery time for me was pretty quick. I had outpatient surgery on Friday and was back to work three quarters time by Wednesday, full time the next Monday. My pre-op diet was a two week "Lean-and-Green" plan. I had a Protein shake for breakfast/lunch and a salad with some lean meat: chicken/shrimp/pork ... whatever. And I'm not talking about a side salad, either. I was using mixing bowls and loaded it with carrots, broccoli and everything. Huge salads and sometimes a whole can of tuna. Hey, my doc said lean and green, he never mentioned size. For snacking, I was allowed a shake. I lost 10 pounds pre-op and afterwards he commented on how awesome my liver looked and how easy it was to work around.

So, I know you're scared as this is a huge decision. Myself, I needed a permanent, fundamental change with my relationship with food. I was/am addicted to food in an unhealthy way. The band may provide a quick fix for awhile, but the health cost would have been enormous and my weight loss, well ... who knows. The sleeve is a permanent change which helps me to eat "normal" portions. That is something I have always wanted, but never had the ability to maintain. I love my sleeve. Don't look at this as a setback, it actually is the best thing that could have happened for you ... I know it.

Continue to research the band and the sleeve. There is a forum here addressing band to sleeve conversions. Talk to everyone including the Dr who held the class. There is a reason he is doing sleeves now.

[dharriott 37]

PDX... Great response and info! Ty

[bradsgirl007 12]

I agree with the other posts. I originally went in thinking bypass only. Then I spoke to my surgeon and he said that he would do any of the three for me but that the sleeve was my best option. I am 33, weighed 250 prior to surgery, and have PCOS and insulin resistance. None of those are considered comorbidities.

My thoughts were like this....I want the best chance at losing the weight and keeping it off possible. I have an issue with Portion Control, as in, I don't have any control! I also stress eat and just eat when something looks or sounds good. I needed something that would MAKE me eat the correct portion sizes. I am going to have to teach myself the rest.

What made my decision is that I am young and lap band does NOT have a good success rate. You can lose about 45-50% of your excess weight with it. The bad news is, most people have slippage of the band or other complications as well as serious weight regain. If I am going to do something like this, it has to be worth it.

As for bypass, I am still not convinced it isn't a good choice for me. I like he negative feedback (slap on the wrist, so to speak) that you get with sweets/carbs. But what I didn't like was the malabsorption ( really decreased absorption of any nutrients ) especially since I may want another child. The re routing of the intestines didn't bother me as much as the fact that the section of your stomach ( the fundus ) that releases the hunger hormone Grehlin would be left in there. I have seen tons of 10 year plus success stories with the bypass and was really close to changing my mind.

What really got me was that with the sleeve, it is the healthier way to go. No malabsorption, main part that makes the hunger hormone is gone (still have some huger hormones that the brain sends out) and long term, I would be healthy enough that I wouldn't have to worry about not being able to carry a baby due to the malabsorption. The weight loss stats for bypass and sleeve are really similar. 65-70 for sleeve and 75 for bypass. But my drs studies have shown about 80% for both.

I was sleeved on 12/28 and am down 16 lbs already. It's only been about 10 days. I am happy with my choice. I hope you come to a decision that is right for you. Please keep in touch and ask all the questions you want!!

[asherje 81]

My mother and I got the band in 2008, self pay because our insurances wouldn't cover it, 13,000each. Biggest mistake of my life. Nothing but problems from day 1. Hardly lost any weight unless I was having complications vomiting constantly or not being able to eat. Over the 5 years had sliming, slippage, pouch dilation, I was working out, still taking phentramine, seeing a nutritionist and was still not losing. Made my life hell for me and my son (now 5). I've spend over 5,000 in last 2 years in doctors offices and hospitals from complications. I couldn't eat most meats, most veggies, had to be rushed to the doctor because I had a piece of apple stuck in the band and they had to open it.

I finally had the band removed and was sleeved on Dec 10th. I don't have the port pain any more, I can lay on my stomach again, I can eat and I'm actually full with my tiny amounts of food. I was hungry most the time with the band. I wouldn't wish it on my ex husband who I hate.

My mom hasn't had the complications as bad, but she throws up most her food, extreme pain in her shoulder at 5yrs out still. Again her insurance will not cover the surgery, she's looking at just having it removed and be done with WLS all together, she'll have to pay out of pocket. She only has lost 30lbs of the 160 excess pounds in 5yrs and that was during the first 6 months. I really recommend going on you tube and listen to the stories of the band, go to the lap band to sleeve area on this forum.

Being you're a mom & have struggled with weight your whole life I would get sleeve or gastric to be honest. I'm a single mother since my sons birth. I've missed out on so much because of that stupid band.

[hinportland 83]

My physician recommended me for the lapband after struggling with obesity since I was young' date=' and the affects my weight is having on my arthritis in my hips and back. I went to the first class tonight to start the process, and the Dr who held the class began talking about how the sleeve has taken the place of lap band in my area.. I'm scared I won't qualify now . My bmi is 37. They kept talking about the risks, and problems you have to have with a bmi under 40 to be able to qualify. I don't have those (yet) although I have arthritis in my hips, shoulders , back , arms and hands, according to my Dr my weight is making my symptoms worse. I'm absolutely miserable, with my weight and no self esteem or confidence. I need and want this surgery to help me, and to be able to live a long healthy life for my children. But now knowing that lap band that I've done so much research on n had it instilled in my head that I could get is no longer available, I'm petrified. I'm so scared to get some of my stomach removed. (Know people who've had bad experience) ... Please tell me the benefits, the risks, the positives over the cons.. lay it out for me please someone!!! I know nothing about this type of procedure. ( sorry for the book I just wrote) [/quote']

Arthritis is an acceptable co-morbidity on most insurance plans. My BMI was 38 (32 now, woo hoo!) but I also have fatty liver, high cholesterol, arthritis, and pre-diabetic. Good luck, I know this is hard.

[hinportland 83]

Also, my sister has lap band and she's had a lot of problems. Lots of vomiting, then stomach swelling, she has to have Fluid put in and taken out all the time (with co-pay). And in 2 years she's only lost half the weight. I'm doing great with the sleeve. Only 6 weeks out, but no complications. I actually feel really good. I've been going to the gym since 4 days post-op. Good luck with your decision.

[ashelaine 382]

I almost lost my sister because of the band. I knew it wasn't for me. She is now on her 2nd band (they removed and replaced dec. 31 2011). I have lost more in 2 months than she has lost in 6 years of being banded without any of the horrible after effects she has had. I can eat whatever I want- I just can't eat as much. The amount of out of pocket she has had to pay for her band issues blows my mind. Good luck in whatever you choose!

[Losing weight 126]

My physician recommended me for the lapband after struggling with obesity since I was young' date=' and the affects my weight is having on my arthritis in my hips and back. I went to the first class tonight to start the process, and the Dr who held the class began talking about how the sleeve has taken the place of lap band in my area.. I'm scared I won't qualify now . My bmi is 37. They kept talking about the risks, and problems you have to have with a bmi under 40 to be able to qualify. I don't have those (yet) although I have arthritis in my hips, shoulders , back , arms and hands, according to my Dr my weight is making my symptoms worse. I'm absolutely miserable, with my weight and no self esteem or confidence. I need and want this surgery to help me, and to be able to live a long healthy life for my children. But now knowing that lap band that I've done so much research on n had it instilled in my head that I could get is no longer available, I'm petrified. I'm so scared to get some of my stomach removed. (Know people who've had bad experience) ... Please tell me the benefits, the risks, the positives over the cons.. lay it out for me please someone!!! I know nothing about this type of procedure. ( sorry for the book I just wrote) <img src='http://www.bariatricpal.com/public/style_emoticons/<#EMO_DIR#>/sad.png' class='bbc_emoticon' alt='' />[/quote']

In this procedure, the bariatric (weight loss) surgeon will remove approximately 60 to 80% of the stomach along the greater curvature, leaving only a small tube, or 'sleeve' for the new stomach pouch that extends from the natural stomach opening to the natural stomach outlet (pyloric valve). The procedure helps limit eating by reducing the overall size of the stomach and helps control hunger by removing the part of the stomach that produces the hunger-stimulating hormone Ghrelin.

The cut-away part of the stomach is removed from the body and not left in place, therefore the stomach reduction is permanent and the gastric sleeve procedure is not reversible. Overall, it is a less complicated operation than gastric bypass surgery, since the pyloric valve and small intestine are left intact. Also, the gastric sleeve does not involve implanting a medical device into the body in order to restrict eating as with adjustable gastric banding surgery.

Advantages of the gastric sleeve

The advantages of gastric sleeve surgery for obese patients are manifold. The greatest of these is safety: the likelihood of complications from the less-complicated gastric sleeve procedure is lower than that of gastric bypass surgery, which is more complex surgical operation.

The second big advantage of the gastric sleeve is its convenience: the patient doesn't have to schedule frequent follow-up office visits, as is the case with patients who undergo Lap-Band surgery and need to see their doctor several times in the first year to have the band adjusted. Current data also indicates that the gastric sleeve results in quicker weight loss than gastric banding.

In addition, the gastric sleeve procedure doesn't require as much active follow-up participation on the part of patients. Patients can get back to normal life that much faster.

Gastric sleeve patients experience fewer restrictions on the types of food that they can eat. The possibility of overeating is itself greatly lessened as well, since the part of the stomach which produces hormones responsible for stimulating hunger is removed from the digestive system during a gastric sleeve operation. This is seen by many patients as being one of the great advantages of the gastric sleeve. Although the procedure reduces the size of the stomach and the amount of food that can be eaten, the stomach otherwise functions normally. And, since the pylorus (the 'valve' that allows only measured amounts of food to pass from the stomach into the bowel) is retained during gastric sleeve surgery.

Of course, no form of surgery is foolproof, and the gastric sleeve procedure is no exception. As with all forms of bariatric surgery, the patient must want success and work for success in order for the operation to succeed as a treatment for curing Type 2 diabetes. Dr. Zafrani and your own doctor will work together with you on monitoring and evaluating your post-operative progress on an agreed schedule and regimen.

Gastric sleeve surgery can be the best option for many obese people with Type 2 diabetes, but only as a part of a total lifestyle change. A common-sense program of diet and exercise, along with daily Vitamin supplements and routine check-ups, are vital if the surgery is to succeed. If you're considering bariatric surgery to cure Type 2 diabetes or obesity, contact Americana WellcareCR to discuss the option of the sleeve gastrectomy with bariatric specialist Dr. Jacobo Zafrani.

LAPAROSCOPIC SURGERY

Laparoscopic surgery, also referred to as minimally invasive surgery, describes the performance of surgical procedures with the assistance of a video camera and several thin instruments. During the surgical procedure, small incisions of up to half an inch are made and plastic tubes called ports are placed through these incisions. The camera and the instruments are then introduced through the ports which allow access to the inside of the patient.

The camera transmits an image of the organs inside the abdomen onto a television monitor. The surgeon is not able to see directly into the patient without the traditional large incision. The video camera becomes a surgeon's eyes in laparoscopy surgery, since the surgeon uses the image from the video camera positioned inside the patient's body to perform the procedure.

The benefits of minimally invasive or laparoscopic procedures are:

less post-operative discomfort since the incisions are much smaller

quicker recovery times

shorter hospital stays

earlier return to full activities

much smaller scars

there may be less internal scarring when the procedures are performed in a minimally invasive fashion compared to standard open surgery

GASTRIC SLEEVE AT A GLANCE

Approach: Restrictive

Limits amount of food that can be eaten

Reduces hunger sensations

Anatomy Changes: Stomach

Reduces stomach size by removing 60% to 80% of the stomach along the greater curvature, leaving only a narrow tube or 'sleeve'

Surgery Method:

Laparoscopic

Operating Time:

One hour

Hospital Stay:

Usually 1 day

Adjustable:

No

Reversible:

No

Medical Implant:

No

Success Rate:

90% succesful in curing Type 2 diabetes

Surgery Benefits and Advantages:

Does not require a medical device implant into body

Pyloric valve and small intestine are kept intact

Reduces hunger (the portion of stomach that produces Ghrelin, the hunger stimulating hormone, is removed)

Few food intolerances

Low malnutrition risk

May be converted to gastric bypass or duodenal switch for additional weight loss

Revision option for patients who have had previous gastric band surgery

Time Off Work:

One week

Recovery Time:

One week

Dietary Guidelines:

600 to 800 calories per day during weight loss period (1-2 years, if weight loss is also a goal)

1,000-1,200 calories per day, once goal weight is achieved

eat protein-rich foods

avoid high fat and high calorie foods

avoid carbonated drinks and coffee

Eating Habits:

eat five small meals a day

avoid snacking

do not eat and drink at same time

chew food thoroughly

Nutritional supplements (optional):

Multivitamins

Calcium

Vitamin B12

Weight Loss (obese patients):

Quick rate of weight loss

Short term results primarily favorable, especially in low BMI patients

Expected weight loss 60% to 70% of excess weight at two years in morbidly obese patients

Low malnutrition risk

Disadvantages:

General surgical risks

Not reversible

Requires patient effort (changing diet and eating habits) for initial recovery and weight loss

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