HELP my doc recommeded RNY????

[Tangerine4 0]

i went and saw my surgeon today to schedule my surgery date and i asked my docs opinion and he gave it to me. He said I was the perfect candidate for the RNY gastric bypass. i am just soooo confused I don't know what to do and feel like I need to make a decision and have no one to really talk to. Anyone have this situation?

[GreenChrysalis 1]

Hey Tangerine4,

Ask your surgeon why he thinks that RNY would be better for you. Has he done a lot of lapbands? Is comfortable with doing the surgery? Is he unaware of the latest research about the risks and benefits? Will he still band you and provide you with support and aftercare even if he thinks RNY would've been better for you? You should definitely discuss all of this with your surgeon and make him aware of your reasons for wanting the band. If you still definitely want it and his reasons for suggesting RNY are not compelling enough for you, it's time to find a new surgeon.

Good luck!

[Wheetsin 714]

There are people for whom the RNY is probably better, but this isn't a diagnosis, it's just a recommendation. Factors to consider would include (you don't have to answer these, they're just some of the things that IMO a surgeon/team should consider before making a recommendation... too often I think recommendations are made based on where the largest profit comes from):

• Is your weight putting your health in immediate and serious danger?
  
• Is it a matter of life or death for you to lose weight quickly?
  
• What foods are you most likely to cheat on?
  
• What is your aptitude for modifying behaviors?
  
• How committed are you to follow-up with aftercare?
  

Etc.

Perhaps ask your surgeon why s/he recommended gastric - see what their rationale is. Ultimately it's your decision, but it may help you to know their reasoning.

[hnladue 7]

Ask him why. Maybe he just hasn't done enough bands to see safe with them? Otherwise: Call Dr D.'s office and get the next date for his dog-and-pony show. They are free. Doesn't hurt to 'shop around'.

[Tangerine4 0]

Actually he did explain his reasoning. He said that although the band is a great tool, it isn't perfected yet. These are not his exact words, but he said that they are coming out with more plyable bands so that there isn't as much risk of stomach errosion but that was a small concern of his. Also he knows that I am a sweet eater, a BIG sweet eater and that was a concern of his. Also I have only two comorbidities which are sleep apnea and GERD, so he said that because I don't have any high risk issues that I shouldn't have a problem with the surgery/recovery. I recovered extremely quickly with my 4 c-sections. He also knows that I have four children and have a fairly busy lifestyle and said that the fills can get tricky and in some cases can be time consuming. i do not want this to be an argument over whether the band is BETTER or WORSE then the RNY, I know there is some great tensions between the two but overall it's all WLS in the end. He really did take into consideration me as a patient. He would not recommend one or the other when we first met in September, he told me it was up to me to research both and give him my decision. i asked for his opinion becuase I was still on the fence. And lastly, he made it a point to let me know that he would respect my decision with whatever I choose and of course give me the best Standard of Care that he would give all his patients. I did my research on this surgeon an am going to a Center of Excellence, I just wish I could make a decision.

[Wheetsin 714]

There is no better or worse between the two outside of each person's individual circumstances and lifestyle. Please don't think we're trying to argue which is better/worse. However, this is a BAND board, not a generic WLS board, so a lot of the responses you'll get are likely to be pro-band.

I know many people who have had RNY, and it was right for them at the time. Some now regret it, some do not. I can say that the concern he mentioned about needing fills -- I'm surprised he didn't mention the RNY recovery time. Even laparoscopically, this is often about 6 weeks. With the band, it's often within one week. Just looking at it from logical numbers, fill appoinments (in over 2 years I've had a total of 5, one was for an unfill) take about 10 minutes at the most. So that's less than an hour I've dedicated to follow-up. Oh, plus the post-op visit to have my staples removed. Even after 2+ years, that's still a TON of saved time over an additional 5 weeks of recovery.

The sweets - that's a very valid point. If you're an ice cream junkie, there's a risk you will not lose weight with the band. Unlike RNY, the band itself does nothing to prevent you from eating crap food. Even people who are overfilled and can only eat a few things often find it's ice cream, Cookies, shakes, etc. that go down the best. If someone isn't able to commit to the lifestyle & behavioral changes that come with needing to be responsible for their eating decisions, then the band may not be the best option. They call the band the "thinking person's WLS" for this reason -- we're still accountable. With some of the other procedures, including RNY, this isn't so much the case. You can expect some degree of hand-out weightloss, even if it comes at the cost of great pain.

Best of luck inyour decision. :biggrin:

[Gone4Now 4]

I only know one person who has has the gastric bypass, but she regrets the choice. I've seen her eat ice cream and go through the dumping afterward. She lost over 100 pounds in a year, maintained for about 2 years, and has gained about 50 back in the last year.

Now, she eats anything she wants and has no dumping. I've seen her eat just like she used to with no problems afterward. I feel badly for her because now she is "stuck" with it.

Although, like Wheetsin said, I'm pro-band. :biggrin:

[Tangerine4 0]

I do understand this is a pro-band board and that is why I've been on here so much myself, because for the past 7 months I thought my mind was made up. I guess what I meant was that I didn't want the thread to just bash RNY, but to reinforce why I had originally went with the band.

Truthfully I am very afraid of the RNY and the permanent aspect of it, but I am also scared that I won't lose weight with the band and that I will just end up with bypass in the long run. I just don't want to regret either decision. It is also weighing heavily with me that my doc said that if he were in this position with his own wife he would recommend the RNY over the lap. I hate choices.

Thanks everyone.

[shortgal 5]

Well it's true you can eat around the band, but you can eat around GBP too. Trust me, even if you are a sweet eater, you'll find a way to get "your drug of choice" down with either procedure.

If you've had GBP, and trying to get your fix they substitute alcohol becasue it's metabolised like a sugar, some find they can eat things like cheesecake ( my friend) or cake.

But low Iron counts, rerouting my insides, longer recovery and more complicated, risky surgery was my reason for choosing lap band.

It is a hard choice to make. Good Luck.

[lee41 0]

Did your surgeon mention the "Gastric Sleeve" as an option for you? When I went for my lapband consultation with my surgeon he described the "Gastric Sleeve" as an option. At the time I was a bit miffed because I had already decided on the lapband. Quickly, he realized I wasn't interested and was on board with the lapband for me. Surgery went great, 2 fills thus far have been great, and I now have very comfortable restriction. I have no regrets to this point. Although I certainly ate sweets and carbs before lapband my increased weight came mainly from eating huge portions of 'healthy' food. So the band has been perfect for me. I eat the 'healthy' food' and the band just keeps me from eating too much of the healthy food. Staying away from sweets and bad carbs has not been a problem for me. Having said that, I have read a few posts on this site from people who have been successful with the labband who say that in hindsight they probably would have opted for the "Gastric Sleeve." I haven't researched the gastric sleeve but the few things I've heard about it, sounds promising and it does not have the malabsorption issues of the RNY. Good luck in making your decision.

[hope2bhealthy 2]

OK, so I am about to have my surgery, and when I met with my surgeon last week, we discussed both band and bypass, so I just wanted to pass on what he said to me. I had previously been working with another surgeon, who seemed to be pushing me toward bypass, even though I had said I wanted the band. My new surgeon said that often, if a dr isn't as comfortable with one surgery or another, or as familiar with it because they don't do it as often, that they can push people toward the surgery that they are more familiar with. My new doc does both surgeries equally, so he looks at his patients histories and lives to see which surgery might be better. From what you've said about your dr, that he thinks that the kinks are still being worked out of the band, it seems like he might prefer bypass surgery.

Second, I am a huge sweet eater too, which was discussed. My doc said that, yes, the bypass can help with that problem because of dumping, but that the longer you have your bypass, the more variety of foods you can eat, and most people get back to being able to eat sweets. He said that he has had a lot of success with the band even with people that are sweet eaters, if they are diligent and get their fills. He said that it really depends on whether you're going to cheat with a candybar or with a hershey's kiss. The other thing to consider is that when you are on liquids, you will have the perfect opportunity to get unhooked from carbs. once you get unaddicted, then you might not have as big of a problem.

Third, and this was really the first thing I thought when I saw your post, is that you don't really weigh a whole lot. Don't take that the wrong way, please. What I mean is, you say weigh 225 and want to get down to 135. I don't know what your height is, but you seem to be less than 100 lbs overweight. I personally weigh 285, am 5'8, and so I have about 125 lbs to lose. The doctor said that with the bypass, he thinks that I would lose too much weight, and that he would have to teach me how to cheat so that he could slow it down. And from everything I've read about bypass (and I've read A LOT) it seems that it is not the best surgery for people with less weight to lose. The complications that come with it might be acceptable for someone who is 150 or 200+ lbs overweight and their life is at risk, but they aren't so acceptable when you aren't as big.

Last, at 37 (which is the new 27 so don't be offended), you might also want to consider how losing weight super quickly with the bypass will affect your body. Only you know your body, and your skin in particular, but the older we get, the less forgiving our skin is. You can get saggy skin with either surgery, but it seems more prevalent with bypass because you lose your weight much quicker. Perhaps this isn't a concern for you because you have more $$ to spend on getting everything fixed in the end, but I know that it is definitely a concern for me.

OK, so I think I've already written a book, but hopefully what I've said has helped your decision a little bit.

[Tangerine4 0]

Actually you did write a lot but it was all worth reading. You make many valid points. Just so you know I am 5' 1" so I do have at least 100 lbs that could be lost to get me to what is considered my "ideal" weight. But I would feel great at 145, i've been there before. I also do not have the $$ to be getting anything nipped and tucked and I know my stomach will never be bikini worthy because I had 4 c-sections and all of my boys were OVER 10 pounds. Again, a very valid point.

As far as my surgeon goes, he is very familiar and does many, many band operations. He was even involved in a study for the swedish band and the new band that they recently came out with. He was also telling me that someone is working on a band that will automatically adjust itself so that you will no longer need fills. He's not sure what that technology will entail but that it will be a huge step for the band.

I guess I have some more thinking to do, my surgery is scheduled for April 28th but I have to make a decision so they can submit to my insurance.

Good luck with your surgery.

[hnladue 7]

I thought about both before also. I went with the band because I won't have to give up any foods (just they will be moderated!), no dumping, no rerouting my insides, less risky in some ways, and I will lose slower. Slower I think is better. Gives our bodies a better chance at healing. less lose skin. Also the adjustable part, and removable are a plus! Once you go RNY there is no return!

It's all on you to decide, but we will support your decision and I hope you stay in touch with whatever you decide!

[make33 2]

I found out something interesting last Friday:

My surgeon originally talked to me about the bypass because I had acid reflux, which he said could be exaggerated by the Band.

Friday I went in for my fourth fill and I happened to say to my surgeon, "Well, at least I don't have the dumping syndrome". And he said "The way we do the bypass now, THERE IS NO DUMPING SYNDROME!"

Boy, was I shocked! Knowing everything I do now, without the fear of dumping, I can't positively say which one I would have chosen! Now, I love my Band, don't get me wrong--but it DOES seem that advances have been made. (Especially, too, since there's no fear of liver failure any longer with bypass).

[sharona 2]

Both procedures are just a tool. People have worked around both procedures. There needsd to be a committment in your mind to have a different relatinship with food. Lapband is better in that it doesn't change the structure of your GI tract. And....there are multiple complications with the bypass surgery. I am a nurse and did much research before deciding to have the lapband done and some of that was driven by the number of patients in the community I took care of with complications from bypass. I would consider the lesser risky procedure and continue with psychiatric assistance as well as nutritional support while changing your life.

sharon