Is this the right surgery for ME?

[Cleo's Mom 257]

#1

I want the lap band removed (placed in 2008 by different surgeon) but I am still struggling with the decision to get the sleeve.

Ultimately I know the decision is mine and I have to do what I think is right but I'd like some practical (not philosophical) advice.

To me the main purpose of any WSL should be to improve one's quality of life. If losing weight does that - great. If your medical conditions improve - great. If you can do things you couldn't do before - great. And finally - if you look and feel better - great.

My band is unfilled now and I can eat most anything. It is a crap shoot though as to when I get stuck or feel very uncomfortable and need to make myself throw up. I also get left shoulder pain.

I was diagnosed with GERD many years ago and have been on nexium for about 10 years - so I have no heartburn or symptoms of GERD despite reducing my nexium to 20 mg and only taking it every other day. During this time I have slept elevated.

At age 64 I have chronic back pain and arthritis. Tylenol is not effective. My weight doesn't keep me from doing anything - more so the back pain and arthritis (neither of which improved with my weight loss with the band).

So that brings me to my dilemma:

I am at a BMI of 35 and the surgeon says I can expect to lose about 45 pounds. And I won't be able to take NSAIDS for life to treat my pain.

I have also read that about 1/3 of those who didn't have acid reflux develop it after the sleeve.

I have also heard the word "stuck" and vomiting with referral to the sleeve.

Then there are all the foods (even healthy ones) that one cannot eat after the sleeve.

So, I guess what I am trying to decide is if the sleeve will improve the quality of my life or create problems I don't have now without benefits to my medical conditions (that's asking a lot for 45 pounds).

Any advice - especially from those who didn't have a lot of weigh to lose

[IncredibleShrinkingViolet 22]

I understand your dilemma! I have four rods and ten screws in my back and one knee replaced. I have not had to take ANY pain meds since losing weight and have read about the correlation between fat cells, the hormones they release and inflammation. Seems to be the case, as least for me.

You will be taking supplements to take the place of foods you cannot or should not eat, so don't worry about not getting enough nutrition. If you have a good doctor and NUT, you will probably have more energy than you ever had before. They will test your blood levels to be sure your body is happy and make sure you are losing fat, not muscle! That's very important!

I had GERD before the surgery and it is slightly worse now. However, it is well under control by taking the medication at night before going to bed. A lot of times GERD is simply caused by being overweight because of the extra fat and flesh in the abdomen making pressure on the stomach, and/or by eating the wrong things. I don't eat anything an hour before going to bed, either, and that helps,too.

Now that everything is healed, I can eat just about anything everyone else eats, only less of it. That's how we use our new "tool"! If you want help on the supplements, I would be glad to share with you.

Go for it! You will probably lose more than what the doctors told you, if that's what you want to do, especially if you exercise (which we all need to do! LOL)

[Cleo's Mom 257]

I understand your dilemma! I have four rods and ten screws in my back and one knee replaced. I have not had to take ANY pain meds since losing weight and have read about the correlation between fat cells, the hormones they release and inflammation. Seems to be the case, as least for me.

You will be taking supplements to take the place of foods you cannot or should not eat, so don't worry about not getting enough nutrition. If you have a good doctor and NUT, you will probably have more energy than you ever had before. They will test your blood levels to be sure your body is happy and make sure you are losing fat, not muscle! That's very important!

I had GERD before the surgery and it is slightly worse now. However, it is well under control by taking the medication at night before going to bed. A lot of times GERD is simply caused by being overweight because of the extra fat and flesh in the abdomen making pressure on the stomach, and/or by eating the wrong things. I don't eat anything an hour before going to bed, either, and that helps,too.

Now that everything is healed, I can eat just about anything everyone else eats, only less of it. That's how we use our new "tool"! If you want help on the supplements, I would be glad to share with you.

Go for it! You will probably lose more than what the doctors told you, if that's what you want to do, especially if you exercise (which we all need to do! LOL)

Thanks so much for your very practical reply. I appreciate the information. I just worry most about "quality of life". Like I said, mine is more impacted by my back problems and arthritis than my weight. My weight doesn't seem to hinder me. I have been exercising for years. It is my hunger. I am a volume eater. I keep thinking - if the sleeve controls my hunger - I can do the rest - eat the right foods, eat the right amount, exercise. But I worry about changing what I have now for the unknown. That is always scary.

But for now, I am concentrating on the 6 month diet and the sleep study (I am doing it at home).

Thanks, again.

[LivingFree! 478]

Hi Cleo's Mom,

Please remember that the sleeve will not "control" your hunger. In defining yourself as a "volume eater," you would most likely be quite disappointed. Especially since the RNY is not an option for you, and with your history of GERD, you might just be better off recommitting to your band (if it is not causing you any major problems). If your quality of life is good now, why risk another operation and possible worse GERD as a result of the sleeve.

I think with any procedure we consider, we all hear the worrisome things you talk about. What we don't know is how COMPLIANT those people really are being with their eating program and lifestyle. "Getting stuck and vomiting" that you are concerned about with the sleeve is relatively uncommon--perhaps what you are hearing are people who are eating unhealthy foods or not chewing well, etc, etc.

Good luck with your decision. The sleeve is a wonderful option and complication-free for many people who remain committed to the forever lifestyle, but only YOU know what is best for you.

[Cleo's Mom 257]

Hi Cleo's Mom,

Please remember that the sleeve will not "control" your hunger. In defining yourself as a "volume eater," you would most likely be quite disappointed. Especially since the RNY is not an option for you, and with your history of GERD, you might just be better off recommitting to your band (if it is not causing you any major problems). If your quality of life is good now, why risk another operation and possible worse GERD as a result of the sleeve.

I think with any procedure we consider, we all hear the worrisome things you talk about. What we don't know is how COMPLIANT those people really are being with their eating program and lifestyle. "Getting stuck and vomiting" that you are concerned about with the sleeve is relatively uncommon--perhaps what you are hearing are people who are eating unhealthy foods or not chewing well, etc, etc.

Good luck with your decision. The sleeve is a wonderful option and complication-free for many people who remain committed to the forever lifestyle, but only YOU know what is best for you.

Thank you for your reply. I agree with what you say. However I am still weighing the pros and cons of getting this surgery.

By volume eater I mean that it takes a lot of food for me to reach satiety. That wasn't a problem when I was thin in my teens and early 20's - I ate when hungry, stopped when full and didn't gain weight. That all changed in my late 20's and after my first pregnancy. That's when I started dieting and that's when I started putting on more weight.

As to the sleeve controlling hunger - there are certainly enough posts from people on here who say it does just that. Removing grehlin, not feeling hunger, etc.. But of course everyone is different.

I've gained a lot of insight about food and dieting having been at it over 30+ years. I know genetics plays a big role for me.

I am going through the 6 month diet program and using Alli (which I had a lot of success with before it was removed for product tampering) and see where it goes from there.

Thanks, again.

[Cleo's Mom 257]

My main concern would be the GERD history. It seems that surgeons are split on recommending the sleeve with this history. If the GERD worsens, you may need an additional procedure. Tough call.

Have you considered a second opinion?

Well, I've seen both the bariatric surgeon and my PCP - the surgeon only said she wanted an endoscopy to rule out Barrett's (which I don't have - I've been scoped recently) and my PCP didn't mention anything. But I will bring it up again at my next appointment for my weigh in.

It concerns me that so many young women on here who get the sleeve might develop worsening GERD and may have problems with Barrett's or esophageal cancer in the future.

It IS a tough call. Right now the only "pro" I can think of is that I might lose some weight and look better.

Thanks for your reply.

[LivingFree! 478]

Hi Cleo's Mom,

Please remember that the sleeve will not "control" your hunger. In defining yourself as a "volume eater," you would most likely be quite disappointed. Especially since the RNY is not an option for you, and with your history of GERD, you might just be better off recommitting to your band (if it is not causing you any major problems). If your quality of life is good now, why risk another operation and possible worse GERD as a result of the sleeve.

I think with any procedure we consider, we all hear the worrisome things you talk about. What we don't know is how COMPLIANT those people really are being with their eating program and lifestyle. "Getting stuck and vomiting" that you are concerned about with the sleeve is relatively uncommon--perhaps what you are hearing are people who are eating unhealthy foods or not chewing well, etc, etc.

Good luck with your decision. The sleeve is a wonderful option and complication-free for many people who remain committed to the forever lifestyle, but only YOU know what is best for you.

Thank you for your reply. I agree with what you say. However I am still weighing the pros and cons of getting this surgery.

By volume eater I mean that it takes a lot of food for me to reach satiety. That wasn't a problem when I was thin in my teens and early 20's - I ate when hungry, stopped when full and didn't gain weight. That all changed in my late 20's and after my first pregnancy. That's when I started dieting and that's when I started putting on more weight.

As to the sleeve controlling hunger - there are certainly enough posts from people on here who say it does just that. Removing grehlin, not feeling hunger, etc.. But of course everyone is different.

I've gained a lot of insight about food and dieting having been at it over 30+ years. I know genetics plays a big role for me.

I am going through the 6 month diet program and using Alli (which I had a lot of success with before it was removed for product tampering) and see where it goes from there.

Thanks, again.

Hi again,

A little more on the "sleeve controlling hunger" thing--I'm just really passionate that people understand that the getting the sleeve as a remedy for controlling their hunger is a very slippery slope. Sure, we do read posts here from those during their first year or so where they have no appetite (the honeymoon period). Are you also reading posts from an equal number of people more than a year out who still feel their hunger is controlled and they don't have cravings? There's still a lot of head work/eating/lifestyle changes that have to go on to prevent weight regain after the sleeve--much more than I ever imagined. At four years out, most days my appetite feels like it did pre-surgery. The only difference is that I have radically changed my eating habits to not go to the junk; it is a conscious decision every day to make the right choices. You are aleady ahead of the game because you have those good habits having gone through the Band surgery. So in that regard, you will be able to work your sleeve, but it will not do the work for you.

For what it's worth, I have attended in-person support groups once a week for over four years and heard the stories of thousands of people. And, sadly, way too many who regained 30, 40, 50 or more pounds because of uncontrolled hunger(and old habits).

If you haven't already, maybe hang around the Sleeve Veterans Forum. You have to be one year out to post there, but you can read the posts. There's a few who are 4-5 years post-op who talk about hunger/craving struggles that might give you a little more perspective.

I hope you know that I am in no way trying to discourage you from the sleeve. Like I said, it's a wonderful tool, but you don't want to be one of those people who get the sleeve and then end up feeling like "it didn't work."

[Cleo's Mom 257]

Hi Cleo's Mom,

Please remember that the sleeve will not "control" your hunger. In defining yourself as a "volume eater," you would most likely be quite disappointed. Especially since the RNY is not an option for you, and with your history of GERD, you might just be better off recommitting to your band (if it is not causing you any major problems). If your quality of life is good now, why risk another operation and possible worse GERD as a result of the sleeve.

I think with any procedure we consider, we all hear the worrisome things you talk about. What we don't know is how COMPLIANT those people really are being with their eating program and lifestyle. "Getting stuck and vomiting" that you are concerned about with the sleeve is relatively uncommon--perhaps what you are hearing are people who are eating unhealthy foods or not chewing well, etc, etc.

Good luck with your decision. The sleeve is a wonderful option and complication-free for many people who remain committed to the forever lifestyle, but only YOU know what is best for you.

Thank you for your reply. I agree with what you say. However I am still weighing the pros and cons of getting this surgery.

By volume eater I mean that it takes a lot of food for me to reach satiety. That wasn't a problem when I was thin in my teens and early 20's - I ate when hungry, stopped when full and didn't gain weight. That all changed in my late 20's and after my first pregnancy. That's when I started dieting and that's when I started putting on more weight.

As to the sleeve controlling hunger - there are certainly enough posts from people on here who say it does just that. Removing grehlin, not feeling hunger, etc.. But of course everyone is different.

I've gained a lot of insight about food and dieting having been at it over 30+ years. I know genetics plays a big role for me.

I am going through the 6 month diet program and using Alli (which I had a lot of success with before it was removed for product tampering) and see where it goes from there.

Thanks, again.

Hi again,

A little more on the "sleeve controlling hunger" thing--I'm just really passionate that people understand that the getting the sleeve as a remedy for controlling their hunger is a very slippery slope. Sure, we do read posts here from those during their first year or so where they have no appetite (the honeymoon period). Are you also reading posts from an equal number of people more than a year out who still feel their hunger is controlled and they don't have cravings? There's still a lot of head work/eating/lifestyle changes that have to go on to prevent weight regain after the sleeve--much more than I ever imagined. At four years out, most days my appetite feels like it did pre-surgery. The only difference is that I have radically changed my eating habits to not go to the junk; it is a conscious decision every day to make the right choices. You are aleady ahead of the game because you have those good habits having gone through the Band surgery. So in that regard, you will be able to work your sleeve, but it will not do the work for you.

For what it's worth, I have attended in-person support groups once a week for over four years and heard the stories of thousands of people. And, sadly, way too many who regained 30, 40, 50 or more pounds because of uncontrolled hunger(and old habits).

If you haven't already, maybe hang around the Sleeve Veterans Forum. You have to be one year out to post there, but you can read the posts. There's a few who are 4-5 years post-op who talk about hunger/craving struggles that might give you a little more perspective.

I hope you know that I am in no way trying to discourage you from the sleeve. Like I said, it's a wonderful tool, but you don't want to be one of those people who get the sleeve and then end up feeling like "it didn't work."

Thank you for writing this. I need all perspectives. And more information and facts. My hunger has always been my enemy. I am quite happy eating healthy foods as long as I can eat enough to satisfy me. Unfortunately that has proven to be "too much".

Right now I am counting calories and keeping a food log and using Alli. I will see how it goes. Also unfortunately, due to my age and metabolism it takes fewer and fewer calories to show weight loss.

Thanks again for your information.

[eagersleever15 28]

I am one of the people who was sleeved but I am always hungry! The difference is that I cannot eat very much and I follow the "rules". I also log everything I eat into the "lose it" app. I also work out everyday. I am 10 weeks post op and down almost 50 lbs. (from the beginning of my journey). I love my sleeve! I have no regrets and have not had a single problem. I am 63 years old. Bro was 33

[MichiganChic 3,262]

Only you can decide if it's worth the risk. I had GERD before surgery, and now I rarely have it - and even then, it's if I eat too much. As for hunger, I do have it now, but nothing like before surgery. And as for your concern about benefit vs. risk, I think that's a good question. I always encourage people to think about that, and I am usually the one trying to dissuade people with small amounts of weight to lose from having surgery.

However, in your case, I assume your weight is lower because of a band. If you were to remove it and get a sleeve, you might be pleasantly surprised at how effective the sleeve is on a volume eater. I was both a volume eater and a grazer, and the sleeve cured me of the volume eating. I have to really work on that grazing habit.

Regarding weight loss and pain, I've found a proportionate amount of pain to weight. The more I lose, the better I feel. I had generalized pain all over, and my joints ached all the time. As I lost weight, the majority of it went away. I have a knee that needs to be replaced, and just a few pounds - like less than 10 - really makes a difference for me. I can tell that I'm going in the wrong direction based on that knee. My point is, that last 45 pounds you have to lose could make more of a difference than you realize. I was a little surprised that a few pounds when you are at a normal weight could make that big of an impact.

One other thing - I can eat pretty much anything. Have never vomited or slimed, and can eat more than a couple bites at a time. I live a totally normal life when it comes to food and eating - including having to watch what I eat to stay thin.

[Cleo's Mom 257]

Since I posted my original post I have done a lot more research on here as to the many outcomes and experiences that people have with the sleeve. Most are happy as clams, but when I read further it is because losing weight really changed their lives by making them healthier. They could now do things they couldn't do before. And many of their co-morbidities either improved or went away. And they look better and love that, too. So, because of this they put up with and tolerate the difficult side of the sleeve - they have regained their hunger; they have daily diarrhea two years out (or chronic constipation), they can't tolerate plain Water. They developed worsening GERD, they have sagging skin, they are depressed, they want to eat real food (some can, some can't), etc.. Everyone is different and there are NO guarantees with any WLS as to what YOUR experience will be.

Getting healthier never happened to me when I lost 75 pounds with the band (only 15 from the band the rest was me dieting and the liquid only phases). My back problems are my biggest health problem and they got worse after the band. I spent most of 2012 in doctor's office trying to find out what was wrong with me. It took two trips to the ER to find out. Not being able to take NSAIDs for my back and arthritis (my surgeon told me this) is a big factor as is GERD. My husband died of esophageal cancer after having Barrett's esophagus so I know what GERD can do.

I am in onderland now and will keep trying to lose weight by counting calories and exercising and using Alli. But for now, I am not doing the sleeve.

Thank you, everyone, for your helpful replies. I wish you all continued success.

[MichiganChic 3,262]

Good choice. You should never take on a major risk like this without really understanding it and how you would feel about it. I always tell people the risks are low, but if you have a complication, you have it 100%. It's not for everyone. I would not have had this surgery if I was at or under 200 pounds. I am surprised at people who have a BMI of under 30 and are having WLS of any kind to prevent further weight gain. In my opinion, that is a not a case of benefit outweighing risk.

Good luck to you!

[Cleo's Mom 257]

Good choice. You should never take on a major risk like this without really understanding it and how you would feel about it. I always tell people the risks are low, but if you have a complication, you have it 100%. It's not for everyone. I would not have had this surgery if I was at or under 200 pounds. I am surprised at people who have a BMI of under 30 and are having WLS of any kind to prevent further weight gain. In my opinion, that is a not a case of benefit outweighing risk.

Good luck to you!

My surgeon's website even says that if you don't have 100 pounds to lose the risks of bariatric surgery outweigh the benefits. I've already been through one failed surgery so at this point in my life I am not ready to take that chance on a second one. Thanks for your reply.