Possible revision from lapband to bypass..LOTS of questions!

[marieze 5]

I was banded 8 years ago by a very prominent bariatric surgeon here in Oregon. I started out at 376 pounds. I have ALWAYS had ban issues that mostly centered on vomiting, sliming etc. long story short, in 2014 I started having such reflux problems that I was awakened every night with vomit coming out of my nose. I was terrified I was going to aspirate on my vomit and die. I had 2 endoscopes which proved the band was fine....2 upper GI's which showed some backing up.....and numerous other tests. Finally in Sept. my bariatric surgeon had me do a cats an which determined I had gallstones! I was thrilled she finally figured out what the problem was. She took out my gallbladder which was a piece of cake surgery, but two days later I almost choked on my vomit again! Un-flipping believable! When I told her she said the band has to come out. I hadn't had any Fluid in the band for some time so 10 days after my gallbladder coming out my lapband came out. For me, just like the gallbladder surgery, it was a no-brainer. I went back to work (I'm a field sales trainer) two days later.

So here it is Febuary and I haven't been back to see her until TOMORROW! I've blown her off because I was ticked thinking that my gallbladder didn't really have to come out. That said, everything with the band did check out and I DID have gallstones......

Anyway, I still believe she is the best around. I know that she won't revise to a sleeve as she mentioned in the past she won't due to scar tissue. She will revise to bypass though which I'm seriously considering. I REALLY NEED Y'ALLS HELP....since the band came out 4 month ago I have gained between 40-50 pounds if you can believe it.....I AM SO EMBARRASSED to even write that. So here are my questions/concerns.....

A. Do I have to jump through all the hoops again with the psychologist, nutritionist etc. if I do this? I want to move quickly if I do this.

B. Having just had 2 surgeries in October do I have to get all new blood work etc?

C. Do most bypass patients spend 2 night in the hospital

D. In revision, how long did you have to do all liquids?

E. Post-op....how long liquids until puree's then finally solids?

F. Do you find it daunting Vitamins for the rest of your life? Are they expensive?

G. If you need 60-80 grams of Protein per day yet can only intake 1/4 to 1/2 cup of food, how am I reading that people eat apples etc. doesn't almost all food need to be protein? Any way around drinking the shakes?

H. How do fats work? I try to eat a low carb diet yet I do enjoy my salad dressings, butter and olive oil?

I. It freaks me out that one can gain weight and stretch out their pouch....hence landing up where they started. This surgery is so final but it would be worth it if I keep my weight off. My main problem is my appetite!

J. Is it like the band in that you can really eat pretty much anything but just smaller portions...like really small?

I am so grateful for any and all information you can share with me. I find the best way to get educated it to ask those who have walked before me! Oh, one more thing....my new insurance which is Blue Shield of Calif. Isn't as good as my previous insurance. I have a $1,000 deductible and I have to pay 20% of everything else. So I really have no idea what I'm looking at financially. As a single mom this may be a problem. I know they cover bariatric surgery but that's all I know. Again....I appreciate everyone's feedback!

Marieze

[BeautyLocs40 16]

Hi, Marieze--

My revision is scheduled for Tuesday, so I can be only somewhat helpful. I was banded in 2009, lost 50 pounds, and stalled. I've managed to keep off all but 10 pounds, but I'm still about 130 pounds overweight. I, too, considered the sleeve, but an unexpected side effect of having the band removed was horrific GERD complete with vomiting. My surgeon said the sleeve could make things worse, and recommended the bypass. Admittedly, I'm a bit scared about having my insides re-worked, but it is the "gold standard", and given my lack of success with the band, I suppose I should go big or go home, right?

Anyway, I can answer the following questions based on where I am to date in the process:

A. Do I have to jump through all the hoops again with the psychologist, nutritionist etc. if I do this? I want to move quickly if I do this.

If you want your insurance to pay for your surgery, yes, you will have to jump through the hoops. I had to do a six month, medically-supervised weight loss program, get clearance from my psychopharmacologist and social worker in addition to seeing the program's psychiatrist. I've been at this since December 2013.

B. Having just had 2 surgeries in October do I have to get all new blood work etc?

This depends on the hospital's policy. The one I'm going to considers blood work current so long as it was drawn within six months.

C. Do most bypass patients spend 2 night in the hospital

I've been told to expect two nights in the hospital.

D. In revision, how long did you have to do all liquids?

I have to do seven days prior to surgery and then three weeks after.

E. Post-op....how long liquids until puree's then finally solids?

The nutritionist advances each patient's diet based on their recovery and progress. I don't know exactly.

F. Do you find it daunting Vitamins for the rest of your life? Are they expensive?

This is one of the things that scares me about the bypass. Some of the regular prescription pills I've been taking have been switched from once a day to twice a day in addition to the new supplements. I find it challenging to remember to take pills more than once a day. It will be truly daunting for me to change my habits. As to cost, a friend who had the bypass three years ago told me about costco supplements. They are cheaper than other retailers and of good quality. I've been able to get everything I need without spending a mint. Another friend finds her supplements at Walmart.< /span>

I can't answer your remaining questions. Perhaps someone who currently lives the bypass will respond to your post.

Good luck with your decision.

Regards,

Bridgett

[Shanna213 7]

I've been exactly where you are. I had my band done in March 2011 and lost about 50 pounds but had a terrible time with reflux slimming and poor eating habits because that was easy. Several of my friends started getting the sleeve so I went to my surgeon to ask about getting the sleeve. He did not recommend the sleeve for me because of the reflux and suggested RNY. That was in October. I told him I wasn't sure about bypass but we went ahead and started pre op things such as a sleep study and an EGD. My band was in pretty good position but due to the reflex I had all the Fluid taken out and had gained back 40 of my 50 pounds that I had lost previously. So we decided to go ahead with the RNY. I was very nervous but the more research I did the more I decided this was my best option. I needed accountability with sugar. Also the sleeve is more restrictive only which I had already failed with the band so I was also looking for the malabsorption. My insurance approved the revision and I had an out of pocket expense max of 2500 dollars for the year. Went on two weeks of liquid I lost 8 pounds had my surgery on February 13th. I plan on staying on Clear Liquids for one week not even doing shakes only watery Proteins like Isopure and nectar which aren't half bad. The pain is pretty moderate. I think the site of my port removal is the worst. I only stayed one night in the hospital and went home late the next afternoon. So far so good if I can keep moving and keep the pain under control. I will not fail at this like I did the band I'm bound and determined. I do not regret going ahead with the RNY instead of the sleeve.

[Lauren23 35]

Answering to the best if my ability. I was banded in 2006. Always had GERD issues or unsuccessful long term weightloss. I went straight band removal to bypass in one surgery. I did not want multiple procedures though some surgeons insist on letting your stomach heal first. Mine is fantastic and I trusted his skill. I had gallstones and amd gallbladder removal at 14 and it never made me throw up in the night! That's classic band issues to me and you're right very dangerous.

A. Do I have to jump through all the hoops again with the psychologist, nutritionist etc. if I do this? I did not have to jump through too many hoops bc my surgeon deemed removal of band medically necessary and suggested rny. He was also a "center of excellence" meaning they hold a high standard along insurance companies and are more trusted. I had to have an endoscopy, 2 nutritionist visits (mine actually did I two in one for me bc I begged) and psych eval but that was it.

B. Having just had 2 surgeries in October do I have to get all new blood work etc? Yes and you need it to determine Vitamin levels etc before a surgery like this. You don't want to be deficient going in.

C. Do most bypass patients spend 2 night in the hospital. Many spend 1-3. I spent two but that was bc band removal was very painful for me.

D. In revision, how long did you have to do all liquids? 3 weeks post op.

E. Post-op....how long liquids until puree's then finally solids? 3 weeks liquids, 9 weeks soft foods (only pureed at first then soft meats etc).

F. Do you find it daunting Vitamins for the rest of your life? Are they expensive? Yes but not outrageous. My health is most important. They are expensive if you get fancy ones from your surgeon which I will take for a year bc they are the most trusted and I'm not messing with my health.

G. If you need 60-80 grams of Protein per day yet can only intake 1/4 to 1/2 cup of food, how am I reading that people eat apples etc. doesn't almost all food need to be Protein? Any way around drinking the shakes? shakes are great bc you can get 30 g of protein in a shake. First 4 weeks I had two a day. That was all my protein. I'm six weeks out of surgery and know I have one shake and eat protein first at meals. Sometime protein is all I have other times I add veggies. Fruits should be last. (There is fruit in my yogurt double win).

H. How do fats work? I try to eat a low carb diet yet I do enjoy my salad dressings, butter and olive oil? I am doing low fat when possible (except some cheese that's my weakness). Olive oil is a good fat. I am not over thinking the fats. Some fat is good. No ribs, ribeyes etc.

I. It freaks me out that one can gain weight and stretch out their pouch....hence landing up where they started. This surgery is so final but it would be worth it if I keep my weight off. My main problem is my appetite! So far best thing about this surgery is having less appetite. I never really had that with band. Good would her stuck and painful but I didn't exactly feel full or satisfied. Now I feel satisfied. I will do my best to not stretch out my band but at least we have malabsorption to help us out. They did not take out as much Intestine on me bc my bmi wasn't over 50. There is a food routine you can do if you stretch out your pouch to help it shrink. But don't go there.

J. Is it like the band in that you can really eat pretty much anything but just smaller portions...like really small? My band was very inconsistent. It was super tight in the morning and lose at night (sometimes). Mornings I couldn't eat eggs and night I could eat pizza. The restriction is different. I don't throw up now or make myself. I don't get stuck. I just feel full. All my avid reflux is gone. It's a wonderful feeling. I wish I had this to begin with. The band is a horrible procedure for many. Half of them inserted have already been removed. Many respected surgeons have quit doing them entirely. The pharma company that makes the band has been trying to sell it. Many banded patients do not do quite as well when switching to rny as first time surgery folks. We know the tricks of the trade, how to cheat, and are used to severe restriction. Just be aware of this and work the program. Many have great success too. You will experience stalls. Keep pushing through.

HW 296 (in 2006) SW 237 CW 212.

6 weeks out. Goal weight 160. I am 5'5".

[Band2Sleeve2015 5]

I have a band and will be having it removed and the sleeve put in.. My Dr had no qualms about it.. Should I be worried?

[Lauren23 35]

Band to sleevers have higher complication rates. You're more likely to have a leak which is serious. Also, I saw the forum band to sleeve to bypass on here and that was enough for me to rule out the sleeve. I had one surgeon that was going to sleeve me. I switched surgeons after detailed research and reading various medical studies. Nobody wants bypass but it is the gold standard. Band didn't have long term data a lot like the sleeve now. At least with bypass, I know what I'm getting into.

Edited February 15, 2015 by Lauren23

[goregalore 16]

I haven't had the bypass revision but I am waiting for my insurance approval for it. So I'll give you all the info I have from all my pre-ops and such. I also wanted to mention I had decided on a band to sleeve revision since beginning of last December but after my esophageal manomtry test came back, my surgeon recommends the bypass.

A. Do I have to jump through all the hoops again with the psychologist, nutritionist etc. if I do this? I want to move quickly if I do this.

I switched surgeons from the one who did my lap band in 2010 because he doesn't do revisions and I did have to see the nutritionist and psychologist again. I knocked out both appointments in about an hour in the same building so it was no big deal. I had to go through a ton of pre-op tests I didn't have to do for the lap band but it could be surgeon specific.

B. Having just had 2 surgeries in October do I have to get all new blood work etc?

From what I understand and have been told, bloodwork lasts 30 days... So I would say yes to more bloodwork.

C. Do most bypass patients spend 2 night in the hospital

My husband spent 1 night total and my surgeon told me to expect 2-3 nights total because I'm a revision and recovery can be harder.

D. In revision, how long did you have to do all liquids?

My surgeon requires a 3 day pre-op liquid diet and 1 week clear liquids, 1 week full liquids, 2 weeks pureed. He said by 5 weeks out, I should be on solids no problem.

E. Post-op....how long liquids until puree's then finally solids?

See above.

That's all I can really answer. Hope it helps some!

Edited February 15, 2015 by goregalore

[BeautyLocs40 16]

Hi, lesliesnavely--

I was initially considering a sleeve and did quite a bit of research before my doctor told me the RNY would be a better choice given the GERD. Have you checked out the band to sleeve forum on this site? It's a very active group, and I think you'll get a lot of insight. All of the procedures carry some complications, but it seems former bandsters that have been revised to the sleeve have good success.

Good luck!

[Golflady 19]

@ marieze. Other than the gallbladder surgery I have been through the same thing (including gaining lots of weight in a few months) most likely with the same doctor here in Oregon. I am now gone through bypass eight weeks out and it's been the best thing I've ever done. hang in there. I believe she is the best surgeon around she knows what she's doing! For me I did not have to go through all the classes again but I did have to do pre op appt and blood draw and three days of liquids before surgery. I spent one night in the hospital and be sure to get antinausea medication when you get released.

[LSF 264]

I have a band and will be having it removed and the sleeve put in.. My Dr had no qualms about it.. Should I be worried?

No don't be worried. I just had the revision from band to sleeve. My surgeon said that's what he's been doing with most of his lapband patients

[Band2Sleeve2015 5]

No don't be worried. I just had the revision from band to sleeve. My surgeon said that's what he's been doing with most of his lapband patients

My Doc said the same thing. In fact she said she almost cringes when some opt for the band because she has done so many revisions.

[goregalore 16]

I have a band and will be having it removed and the sleeve put in.. My Dr had no qualms about it.. Should I be worried?

I was actually set on having the sleeve until my surgeon found out my esophagus is weak from the esophageal manomtry test he requires pre-op. I've had a complete unfill for over two years and still get stuck very often. He mentioned the sleeve may act more like the band and cause me issues so recommended the bypass.

[Djmohr 6,965]

I wanted to respond to a couple of your questions about living after RNY since so many of the others have been answered. I am 5 months post op from RNY and doing fantastic. Best decision I ever made!

I can pretty much eat anything just in much smaller amounts. I happen to be one of the lucky folks who does not get bouts of dumping syndrome. I have tried sweets (just a taste) but have found I no longer care about that stuff. They say, you crave what you eat. I have worked hard to focus on eating primarily Protein and vegetables. My pouch loves those foods!

Occasionally I will have a bite of potatoes or rice just to get a taste. I do not worry too much about fat, i eat cheese, Jerky, nuts, real butter, olive oil. The thing is, if you stick to your measurements it all works out. It truly is about eating the right things. I DO NOT eat junk food of any kind.

As far as supplements go, I thought they would be a pain as I hated taking Vitamins pre surgery. Having this surgery has allowed me to get off all other meds with the exception of thyroid replacement. Trust me, I was on a lot of meds! Taking Vitamins daily for me is no big deal and less costly than my prescriptions. I purchase in bulk from costco.

I wish you the absolute best with your upcoming decisions. Don't be afraid of taking the steps to RNY, it works! You still have to do your part but there is a reason it is the gold standard.

I only wish I would have done it sooner. For the first time since I was in my teens, I feel fantastic. I have more energy and stamina!

I have been given a whole new life!

[Kimmi0524 0]

I wanted to respond to a couple of your questions about living after RNY since so many of the others have been answered. I am 5 months post op from RNY and doing fantastic. Best decision I ever made!

I can pretty much eat anything just in much smaller amounts. I happen to be one of the lucky folks who does not get bouts of dumping syndrome. I have tried sweets (just a taste) but have found I no longer care about that stuff. They say, you crave what you eat. I have worked hard to focus on eating primarily Protein and vegetables. My pouch loves those foods!

Occasionally I will have a bite of potatoes or rice just to get a taste. I do not worry too much about fat, i eat cheese, Jerky, nuts, real butter, olive oil. The thing is, if you stick to your measurements it all works out. It truly is about eating the right things. I DO NOT eat junk food of any kind.

As far as supplements go, I thought they would be a pain as I hated taking Vitamins pre surgery. Having this surgery has allowed me to get off all other meds with the exception of thyroid replacement. Trust me, I was on a lot of meds! Taking Vitamins daily for me is no big deal and less costly than my prescriptions. I purchase in bulk from costco.

I wish you the absolute best with your upcoming decisions. Don't be afraid of taking the steps to RNY, it works! You still have to do your part but there is a reason it is the gold standard.

I only wish I would have done it sooner. For the first time since I was in my teens, I feel fantastic. I have more energy and stamina!

I have been given a whole new life!

[Kimmi0524 0]

Than you for posting that. I am planning a revision and was turning more to rny then started questioning my thoughts.