Band to sleeve...some questions and concerns

[William 2010 5]

Hi all, I having been lurking through these forums for some time, but now have a few questions. I will try to give a quick recap of my history and then get to my questions. I will post this in a few different areas of the forum so you may see it in other places.

I got the lap band about 4 years ago at 375lbs. Lost maybe 35lbs from the band and another 50lbs from hard work, dedication, and about 1 ½ hours in the gym daily bringing me to 290. A lady in my doctor’s office (she is no longer working there) was giving me blind fills (they normally place us under the xray to see how we swallow and if we are too tight). Obviously I was too tight, had bad acid reflux one night, some went into my lungs. My doctor unfilled me a bit, I then went to NY for a month (I live in NC). Stomach was irritated and band slipped, went to ER in NY where they took all Fluid out. Went back home to my doctor, they had me unfilled for 4 months. Ravenous hunger and a little depression ensued and I gained weight back and plateaued at 324. Had a few other issues similar to the above where the band would get irritated causing pain/discomfort. The take away is that the band stopped working, I am still at 324 and about to have my info submitted to insurance for a revision to the sleeve.

A more recent complication is where I said enough was enough with the band. The band can often cause pressure in the stomach/esophagus area causing acid reflux. I never have heartburn, but one night it appears I had “silent” acid reflux which cause swelling in the back of my tongue and voice box. The swelling was very weird, at times I would be sleeping and how I was breathing would irritate it and I would wake up with that area quivering/shaking (this has since gone away). I get the lump in my throat feeling ever so often. Doctor put me on protonix temporarily to reduce acid and allow stomach irritation to go down. I went to a throat doctor who looked at the swelling in my throat and said to stay on the protonix and allow about three months for the swelling in my throat to go down (it takes some time for it to heal I guess), but the swelling was consistent with acid reflux flare up’s that get into the throat. So here are some questions and concerns:

1. If I didn’t lose much with band, is the sleeve the best option? I would feel like all hope is lost if I went through with the sleeve surgery and lost 30lbs and nothing more. I would be heart broken. I am very active and very dedicated, not lazy by any means, but to go through this again and not have the surgery meet me half way would be difficult to deal with. I eat healthy and exercise, people in the weight loss office can’t even believe I weigh 324lb because I don’t look it. I have a high muscle mass, but none of that helps when it’s hiding under fat J

1. I’m concerned that if I have acid issues now (never have in the past other than a couple instances of late eating and band being too tight as stated above) is the sleeve the best option? The gastric bypass literally bypasses any acid reflux issues, but the doctor has not said I have acid reflux issues. Could the protonix be masking any symptoms that could come back post-surgery? Doctor also said I could go either way, sleeve or bypass. He said that because I was “successful” with the band that the sleeve would be a good option, but it was up to me. He supports me in whatever I decide.

1. Will the lump in my throat go away? I attribute this to the band as I have heard similar stuff from those who have been banded. One woman said anytime food passed through the band into the stomach it would spasm. It could also be from the swelling in my throat. Just curious is anyone ever had a “lump in throat” that went away after having the band removed.

1. For a while I thought I had anxiety. I had tightness in my chest, lump in my throat, tightness in my throat, etc… I started getting anxious thinking I had anxiety; I’ve never been that type of person. Then I had this idea that it might be the band. As soon as he took out the fill from the band the tightness in my chest went away. I still get tightness in my throat/lump in my throat which I know can be attributed to anxiety, but the throat doctor also said that I have the swelling in my voice box/throat/back of tongue. So I’m thinking that is the reason for the tightness. Anyone ever deal with this or something similar? Here is a good explanation of this: http://www.doctoroz.com/blog/jonathan-e-aviv-md-facs/i-have-lump-my-throat . As a side note, the doctor wanted to fill the band to check for a port leak and when he did, almost immediately, the tightness in my chest and throat came back. So if anyone who reads this is dealing with a similar thing, do not worry. Talk to your doctor.

1. Because it is common for those with band-to-sleeve surgery to not experience the weight loss as those who get the sleeve first, might the bypass be a wiser choice for me? I’m not asking you to predict my future, just your thoughts on the matter. Why would you choose sleeve over bypass? Etc…

This will be it for now, but as we discuss I will definitely have more questions. Thank you all for your help. I do appreciate any feedback and input you might have. I have twins coming in July, will have surgery before and I want to get the best option for me. Just worried I might have the same results with the sleeve as I did with the band. The band did not meet me half way.

[Hynita 113]

To me it sounds like you would be better off with the bypass. People say if you have reflux with the band you will have it with the sleeve. If I was you I'd do bypass that way you don't have to do a sleeve to bypass later. Just makes more sense to me. Good luck and hope all goes well.

[Recycled 2,182]

There are basic general guidelines that most follow when deciding which type of WLS procedure they are contemplating. And then there are specific personal medical, emotional and psychological considerations that require professionals to evaluate.

I am not a doctor, nor do I play one on TV or online forums. You have alot of specific personal considerations and my advice (again.....not a Doc, but still good advice) would be to pose everything you stated above to the professionals.

Once you've decided on a procedure, then by all means bring any concerns you may have to the forum for those with experience with that particular procedure to help you with general information in that regard. Good Luck.

[William 2010 5]

I understand what your saying. Here's the thing, my doctor is fine with me doing the sleeve or the bypass. He says I am a candidate for both and he supports me with either decision.

Granted I am dealing with some issues related to having the band, but I have been diagnosed with no actual issues. These are just concerns I have because I have read about so many different experiences that people have had here in these forums and I want their input.

As of right now the sleeve has been determined by myself and my doctor. Nothing I said above has not been said to my doctor. The request is going to insurance next week. I'm just in the last days here where I need to finalize whether the insurance request will state sleeve or bypass.

[Recycled 2,182]

Then I would review both the sleeve and bypass forums and formulate my own opinions base on the information garnered about each particular procedure. I would even browse the "Band revision" forum as well. It is unrealistic to rely on someone's evaluation of the benefits or negative aspects of a procedure they did not have.

The two procedures are inherently different and you need to make an unbiased decision on which one will meet your expectations and capabilities. Not base it on what someones prejudicial views are due to their choice or the particular forum that is being represented.

In other words. Just simply ask why someone chose their procedure in the bypass forum and again in the sleeve forum and not to compare the two procedures. They've already chosen or had the procedure.......exactly what do you think they'll say.

Good luck.

Edited March 26, 2014 by Recycled

[piercedqt78 658]

I had severe reflux with my band, I was sleeved last May, and have been on protonix since then. I was at goal in 6 months. I love my sleeve, and I'm glad I did that instead of the bypass, as I can have sugar in small amounts, and the surgery did not reroute, or remove any of my intestines. I don't have any problems with reflux with my sleeve, and I have been able to reduce my protonix dose by half. I will try to stop it all together in May at the one year mark. But even if I have to take it for the rest of my life, I will gladly do that, if that's what it takes to stay thin. Since I can't use most sugar substitutes as they cause my to have severe Migraines, I opted to not have the bypass, because that would seriously limit what I can eat, but with the sleeve I do fine with a bit of sugar, or a few extra carbs.

[Band07 374]

I had a lot of heartburn/reflux with the band and have not had one bit with the sleeve.

[rbtnln 81]

Here's my 2 cents if you want it. I had the band and had many of the similar experiences you did. I have been far more successful with the sleeve than I ever was with the band and I'm only 4 months out. The sleeve was developed to be a precursor to by-pass. It was developed for by-pass patients who couldn't be under anesthesia for the length of time needed but needed to get some weight off before they went for by-pass. It became an approved WLS because those patients were so successful with it that they didn't need the by-pass.

If you get the sleeve and then subsequently need a by-pass, you've gone the same path that the sleeve was intended to be utilized for. If you get the sleeve and you're successful, and don't have to by-pass your intestines, why not go for it?

I'm a huge sleeve fan. Just remember (I saw Dr. Now say this on "My 600-lb life"), getting WLS doesn't prevent you from eating all day. It just prevents you from eating a lot at one sitting. It's very true. You can sabotage your success by eating too often, eating the wrong things, etc. with the sleeve. The same can be said for the band or for by-pass.

You seem very motivated and just want to make the right decision. No one can make that for you. Hopefully you'll be able to gather enough information in this forum to come to a decision that you're comfortable with. Good luck and safe travels on your journey!

[BellaHugz 331]

I am a Band-Sleeve revision patient and so happy I did it! Lapband life I begain throwing up and having reflux the issue from any kind of Protein I ate it was really bad. I had every endoscopy test possible to ensure I was a candidate for the sleeve. I too was on Nexuim during that time. My revision surgery January and with in a few weeks I was complety off my Nexium and that lump in my throat was gone as well. The best thing about my revision is I can now hug my daughter with out any pain!!

I do not tolerate sugar free products and cant handle sugar like I used too. For me I wanted to be able to eat food and cook food the way my family and I like it. Another deciding factor was being able to take and absorb Vitamins so I chose not to do the bypass.

Do your research have all the test you can to help you make an the best educated decession for yourself and above all believe yourself. You can do it!!

[CowgirlJane 14,259]

I have lost about 160 since my revision.

I took a ppi to prevent excessive acid the first few months as per surgeon recommendation but have had no problems since. My surgery was Dec 2011

I feel that you do need to be sure not to bring bad habits from the band into your sleeve life. Example there is no reason to vomit with the sleeve. Don't eat to a full sensation. Just absence of hunger.

I strongly suggest you research the pros and cons by looking at pub med etc for actual studies.