Not much longer! (Or, A cautionary tale about the Lap-Band)

[losing_the_band 133]

About 8 1/2 years ago, I finally got to the point where I was tired of being fat and started looking into having bariatric surgery. I researched everything I could find, and I thought that the Lap-Band was the best fit for me. At the time, the only options available to me were Lap-Band and RNY bypass. VSG was not very common in the United States at the time, and was not covered by most insurance plans. As a comparative light-weight (I was in the high 30s BMI, and just barely had a BMI of 40 the day of surgery), I thought that the lap-band was the perfect solution. At the time, it was being heavily advertised as "the next big thing" in bariatrics, with a projected success rate that rivaled or exceeded the RNY bypass at 5 years out, and was "fully reversible."

So, I got approved by insurance. Everything started out well. Even though I was a "light-weight," once I had decent restriction, I was losing weight at a steady pace. And the restriction? Well, the common practice then was to make the band so tight that you were physically limited in the amounts and types of foods you could eat. We were encouraged to only be able to eat 1/4-1/2 cup of food at a time. The downside to this restriction? Severe acid reflux. My surgeon didn't think anything of it, and gave me the option of taking proton pump inhibitors or coming in to reduce the amount of Fluid. But when you've been fat your entire life, and you FINALLY have the dream of being thin within reach, what's a little acid reflux? Obviously, I chose the proton pump inhibitor. Eventually, that didn't even control the acid. I couldn't eat or drink within 4-5 hours of bed. I was sleeping propped up on a steep foam wedge with another pillow or two on top of it. And I was still waking up choking on stomach acid. Eventually, what broke the camel's back was that my chest was constantly hurting throughout the day, I had a nagging cough, and my voice was noticeably hoarse. I drove the 7 hours to see the doctor to have an emergency unfill. My acid reflux improved, but I was still having severe shoulder pain periodically and athough I'd reached my goal weight and lost 100% of my excess weight, I slowly began to gain weight.

A few months after being unfilled, I received a job offer and moved across the country. My new job was in a tiny town several hours from the closest bariatric surgeon. Of course, even though I was gaining weight, I was much smaller than I started out. The weight gain continued, though. Eventually, I decided to find a new surgeon and get back on track for fills. At the first appointment, he looked at the band under fluoroscopy and said that it needed to be removed or replaced/repositioned, as I'd apparently been living for quite some time with a MASSIVE slip. He was surprised that I hadn't needed emergency intervention, since he said that even with most of the fill gone, I only had a space the size of a pencil eraser for food to pass from the upper chamber to the lower.

At that point, I was interested in revising to the sleeve, but unfortunately, I was told that my insurance at the time probably wouldn't cover it. So, I got a new band. And the only thing that improved was that I didn't have reflux or shoulder pain. I couldn't obtain good restriction, and I was afraid to even attempt it because I was 7 hours from my surgeon. My weight just kept climbing and climbing. At the beginning of this year, I had a major issue. I made the mistake of trying to eat a raw carrot. I'd eaten them regulary. I chewed well. It still got stuck, and I suffered through a severe episode of PBing and sliming while at work. After that, my reflux came back with a vengeance, to the point where I had to have all of the Fluid removed from my band. The Upper GI Series showed no slippage, so apparently I just can't tolerate the restriction anymore (even though I didn't have much in the first place).

Eight years after my original surgery and 4 years after my replacement surgery, here I am. I'm only 10 pounds from my original pre-surgery weight. I finally decided that I'd had enough. It was time for either revision to another surgery or just yanking the damned thing out entirely. What's the point of having it if it isn't doing me any good? Without restriction, it's useless, and my body simply won't tolerate restriction from the band anymore. So, after 7 months of jumping through hoops, insurance denials, appeals, and finally resorting to a peer-to-peer appeal, I am approved for a revision. I'm getting this damned thing removed! I don't have my surgery date yet, but the end is in sight!

I'd originally been interested in the sleeve, but after consulting with my new surgeon and doing a lot of research, I decided the best route would be RNY bypass, due to my metabolism issues and lack of long-term data for the VSG as a stand-alone surgery. I am so sick of this journey and I want it to be over. I'm sick of trying to do things "the hard way." We're so conditioned to think that something has to be difficult in order for it to be worthwhile. I've tried doing it the difficult way, and sure, I lost weight temporarily. I also got tooth and vocal chord damage, issues with my vagus nerve, vigilance about knowing where all the bathrooms are in a building, and my metabolism got shot to hell (even more than it already was with PCOS).

So here's to me finally getting back on the loser's bench and getting on with my life. All I can say is that this has been a long, hard, embarrassing journey, and I'm glad it's finally coming to an end. For those of you who've had long-term success with the band, my hat is off to you, and I hope that you never get put in my position. For those of you who are just looking into the band as an option, all I can ask is that you consider my story and really put some thought into what you are doing. As much as it's reversibility is advertised, this isn't a simple surgery where you can just have it removed if it doesn't work and everything is just like you never had it. If you're in a position where it has to be removed, you're likely to have lasting damage to your stomach, damage to your esophagus or vocal chords, adhesions, scar tissue around your stomach or where the port was located, etc. So please, research, talk to people, network, and KNOW WHAT YOU'RE GETTING INTO. There is no "good as new" after this surgery.

[betrthnever 107]

Thank you for sharing your journey. If I could do it over again i would have gone with the RNY too. I warned my mom against the band but she went with it anyway a year after I did and ended up having to get it removed 3 years later. Even my weight loss provider has admitted that the band doesn't work in the long run and they don't do many of them at all anymore. At least I'm still 20 pounds from where i was at my highest weight (2 years to lose 80 pounds and 1 year to regain 60) and I still have my band (fortunately I never had as many damaging issues with my band and I'd rather have it then be without it). Was denied for a revision back in October of last year and am going to start trying again. I suppose nothing is perfect, in the end. I just think that for me the RNY would have given me a better shot at success.