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

[IcanMakeit 1,318]

You are in a tough spot. In your situation, there doesn't seem to be a risk free course. If you do nothing but remove the band, you risk gaining more weight and developing additional weight related illnesses. If you have the gastric sleeve, your acid reflux could get worse. I don't think it's common to develop long term food intolerances with the sleeve, but I suppose they do happen. And with your arthritis, you don't want to do anything that interfered with your ability to seek pain relief. Pain is debilitating.

I think you need a long talk with both your PCP and your surgeon. Although I was told to never take them, I have heard of people who continue to take NSAIDS after having the sleeve.

[Cleo's Mom 257]

You are in a tough spot. In your situation, there doesn't seem to be a risk free course. If you do nothing but remove the band, you risk gaining more weight and developing additional weight related illnesses. If you have the gastric sleeve, your acid reflux could get worse. I don't think it's common to develop long term food intolerances with the sleeve, but I suppose they do happen. And with your arthritis, you don't want to do anything that interfered with your ability to seek pain relief. Pain is debilitating.

I think you need a long talk with both your PCP and your surgeon. Although I was told to never take them, I have heard of people who continue to take NSAIDS after having the sleeve.

Thanks for your reply. I know I am in a tough spot. The problem with discussing this with doctors is that they all say there are no guarantees and it requires a change in lifestyle, eating, etc.and no guarantees with improvements with medical conditions either.

I lost 75 pounds during the lap band journey (only 15 from the band itself) and none of my medical condtions improved. My chronic back problems actually worsened. I have gained about 30 of those pounds back. I really don't think the unfilled band at this point is doing much.

I just got a cortisone shot in my arthritic knee yesterday and it seems to be helping.

I have a lot to think about but unfortunately I don't think the doctors will offer any solutions. Their job is to do the best pre & post op care and perform successful surgery. They never offer guarantees. They can only tell you risks and benefits and I already know them. Thus my dilemma.

[Bufflehead 6,358]

If I were in your place, I would probably lean towards a bypass rather than a sleeve, due to the GERD issue. For pain relief, I would discuss prescription meds such as Tramadol. And as other posters have noted, not every surgeon says that you can't have NSAIDS after the sleeve in any event.

I have never felt anything "stuck" after being sleeved. I haven't vomited or come close even once. I know a lot of people who are post-sleeve and they are all pretty much the same way.

I am not restricted from eating any healthy (or unhealthy) foods. I choose not to eat bread made with yeast since it makes me uncomfortable. I also steer clear of anything carbonated for the same reason. Neither one is a big deal IMO. I don't have any other restrictions. My sleeve tolerates everything and my doctor hasn't placed any restrictions on me either. I am not sure what foods you are referring to that you say people can't eat after being sleeved.

PS - I am not in your age group, I hope it is okay for me to post here!

[Cleo's Mom 257]

Thanks, bufflehead, for your reply. It's okay that you're not in my age group. I appreciate all replies.

I would not consider the gastric bypass. At my age I have to be concerned about absorption of Vitamins and minerals. I was dx with breast cancer in 2002 and took an anti-estrogen for 10 years that while vastly reducing the chance for cancer recurrence it almost always has the undesirable effect of causing osteoporosis as it did with me. So I need to be able to effectively absorb Vitamins and Calcium as well as nutrients from food. How ironic that the one thing obese women usually have is stronger bones and that was taken from me.

The pamphlet given to me from the bariatric surgery center said there are problems with bread, Pasta, rice and Chinese food. From some on here, they have problems with luncheon meats, beef, raw veggies.

I'm really not too worried about that because I heard all this with the band and I think it is a very, very individual thing as to food tolerances after WLS. You see that in the posts. No 2 people are exactly the same. Some can eat some breads, others can't at all. It's largely a trial and error thing.

[IcanMakeit 1,318]

I think your reservations about the sleeve are valid. Doctors say there are no guarantees because there aren't. It's possible, maybe even probable that none of the negative outcomes of the sleeve will happen to you, but with your medical history, I don't blame you for being hesitant.

If I were in your situation, I might stick with non-surgical weight loss methods. I had great (but not long term) success with the Atkins diet. Perhaps with all that you have learned about nutrition and serving size control while your band was working, you can be one of the rare people who can maintain weight loss long term without surgical intervention.

Whatever you decide to do, I wish you the best.

[Cleo's Mom 257]

I think your reservations about the sleeve are valid. Doctors say there are no guarantees because there aren't. It's possible, maybe even probable that none of the negative outcomes of the sleeve will happen to you, but with your medical history, I don't blame you for being hesitant.

If I were in your situation, I might stick with non-surgical weight loss methods. I had great (but not long term) success with the Atkins diet. Perhaps with all that you have learned about nutrition and serving size control while your band was working, you can be one of the rare people who can maintain weight loss long term without surgical intervention.

Whatever you decide to do, I wish you the best.

Thank you for your reply. I have tried all the diets and then some over the past 30+ years. I have never lost weight unless I felt hungry. Dieting is like holding your breath - it only can last so long. If you are told to eat foods you don't like and not eat foods you like and in the meantime are not feeling satisfied then how long will that be successful? For me, not very long. I'm not advocating eating junk food but as a volume eater who requires a lot of food to feel satisfied, diets have never worked for me long term. I do like healthy foods, but they have calories, too.

I have a lot to think about with regard to this major step and whether it is worth it for 45 pounds. I appreciate all the feedback an advice in the meantime.