My Dr keeps saying no to the sleeve?! help!!

[marlena 0]

Hello all,

My name is marlena, I'm 24yrs old and I was banded in 2004 with an Inamed (smaller/older) lap band. My gastric surgeon (who has been supportive every step of the way and has seen me through more over/under fills and ulcers then anyone) has drawn the line at the sleeve.

He says we should do a barium swallow followed by a gastroscopy once again (have been through this twice before to no avail) to judge why I am having such little success and so many problems.

I have so far (in 4 years) lost 20kgs from my start weight and I’m sitting at 115kgs. My all time low was 100kgs on my 5'10 frame achieved by being so overfilled I would eat and throw up just like a bulimic after every meal as nothing would go down.

My surgeon keeps saying that the sleeve is irreversible and while I come to him now to be "unfilled" when my reflux keeps me awake at night - the sleeve is no better for reflux then the band. He thinks the sleeve is actually worse for it and potentially will mean my gastric juices will do nothing but come straight up every time.

He also mentioned the C word. There seems to be research out there at the moment tracking different types of cancers that have been "induced" if you will by surgeries such as the bypass; and the sleeve is such new territory that the findings should be a huge consideration for me.

His argument about pregnancy with the sleeve has also made me think; he says I increase the risk of being undernourished during pregnancy and breast feeding with the sleeve as I won’t be able to eat as much as I should.

I have taken 2 appointments specifically to discuss having a sleeve done and he keeps pointing at me saying it is too new and once done he cannot undo it. In his words he doesn’t want me to "come crying to him asking him to undo the sleeve" when I hit a rocky road, and I have been guilty of this with him in the past with the band out of sheer frustration!!! I actually cried during our appointment today :thumbup:

I have never known restriction with my band, all I get is from being unrestricted to totally over restricted - no in-between ever!! also I have had several episodes per night even with 1ml in my band where I wake up to throw up this brown clotted looking material and sleep with 4 pillows so I'm in a sitting position in bed....surely this isn’t how the band is meant to work?!

Help me please?!?!?!

Absolutely any advice would be so greatly appreciated...

Thanks for your time if you’re still with me

Marlena

[MacMadame 81]

It sounds like your surgeon is unfamiliar with the sleeve and therefore he is uncomfortable with doing it and coming up with excuses. You need to find a surgeon who regularly does them and is familiar with them and get a second opinion.

As to the things your surgeon says, many of them are not true. For example:

1) Cancer - the sleeve will DECREASE your chance of having both stomach cancer and ulcers. Losing weight will significantly decrease your risk of certain cancers overall including breast cancer.

2) Pregnancy - there is no reason you can't have a baby after a sleeve. You only need about 200-300 more calories a day when pregnant and that can be easily accommodated by having an extra snack each day. There are guys who are consuming as much as 1800 to 2000 calories a day with the sleeve. The sleeve will limit the amount of food you can eat at any one time, but you can eat every hour if you need to (not that you will or should).

3) GERD - generally in the first couple of months with a sleeve, your stomach is producing too much acid for the new stomach size, but it will adjust. In the meantime, this is easily controlled for most people via a daily dose of a PPI. In my case, my GERD got better after my sleeve because of my hiatal hernia repair. A small minority do have significant issues with acid during this temporary period, but most have no issues that taking a PPI can't cure.

4) All WLS is permanent. The band right now is making scar tissue on your stomach that will never go away even when the band is removed. The idea that the band is this safe surgery that is completely reversable compared to all the other scary and unsafe permanent surgeries is, IMO, the Big Myth of the band.

5) The sleeve is not that new. It's new as a stand-alone procedure for weight loss, but it's a partial gastrectomy and those have been done for decades. My aunt had one over 45 years ago, for example, due to stomach cancer. We know the long-term issues with removing part of your stomach and they are few and far between. Mostly, you have to be religious about Calcium supplementation and on the lookout for other possible deficiencies such as B12 and anemia. Otherwise, as long as the pylorus valve is intact, there really isn't much that happens long-term; the main complications are short-term as a direct result of the surgery.

Does your surgeon do anything but lap band? The way he talks about other surgeries makes it seem like he doesn't. A surgeon who doesn't do a particular surgery is not the best source of information about it.

The bottom line is that it's your body, not his, and you owe it to yourself to get another opinion from someone who actually knows what they are talking about and isn't going to use scare tactics to talk you out of what you want.

[marlena 0]

Hi there Jack,

I was thinking I ought to see another surgeon re the sleeve in any event, just to see if I get the same sort of feedback.

I dont really follow any one type of program, I do try to eat well and in moderation... I occasionally go through the Optifast phase then try my hand at wieght watchers but havent been successful on the grand scale.

I spend most of my time fill-less as i dont tolerate restriction due to the reflux and throwing up.

I just keep at it just in case something begins to function properly....

Thanks for the reply

Marlena

[marlena 0]

MacMadame,

Thank you thank you, I was feeling a little down and out after my second failed attempt at talking my surgeon round the sleeve for me.

He was honest in saying he hasnt performed all that many sleeves, but those patients that did the revision surgery were unsuccessful and had a hard time adjusting to the sleeve as it cannot be let out like the band. He even refered me to another weight loss surgeon to have the sleeve done and get a second opinion as he trusts this surgeon more than any other - so in that regard I do believe he has my best interests at heart.

He seems to think my reflux will only get worse with the sleeve and warns me about food coming straight back up at night if im not careful and have digested the food properly. Have you ever had an issue with any of this happening?

The pregnancy bit is a relief, as i read more on this fabulous web site im compiling a list to take with me so i can ask the right questions and make sure im getting the right answers.

Just a quick question, i think adjusting with the band to feeling full around the bra line/chest area took a long time with me - is the new "full" sensation the same with the sleeve or is it more like the old tummy full non banded people feel?

Thanks

Marlena

[MacMadame 81]

When I eat too much, I get a pain around my breastbone, so I think it's the same as with a band. It's definitely not like it used to be. Though I have come to the conclusion that what I used to think was my stomach is actually my intestines!!

There are some successful band to sleever who stop by this board periodically -- I'm hoping they will chime in soon with their experiences. But most of them report the sleeve to be easier. Less getting stuck, less pbing.

I have never had any issue with food coming straight back up and that doesn't seem to be a problem for the people I know in general. I know some people who in the early days did have to be careful not to eat and go right to bed, but that got better over time.

I'm wondering, based on what he has said, if he is still making the sleeves with a 48 - 60 f sizer instead of using a 32 - 34 f as is much more common these days. With the bigger sizes, there was an issue with regain at the 2-3 year mark because there was still enough of the stretchy part of the stomach left. So the surgeons who use that size tend to be down on the sleeve and say it doesn't work.

[Jachut 487]

Mac, you have a pic! You've got a nice skinny face!

Marlena, I think, for peace of mind, if I were you I'd seek a second opinion from another surgeon. I have never heard anything to do with weight loss surgeries causing cancer and I suspect he doesnt want to do the sleeve, is trying to put you off and may well have just made that up. You may have a good working relationship with this guy but I would like to see someone completely impartial.

I think with the band, there are just certain people it does not work well for. It may be as simple as an error in placement. I have a friend from another board whom I also know in real life who was my inspiration to be banded. I'd known about the lapband sort of in the back of my mind but when she did it it started me thinking and I followed 6 months after. Unfortunately for her, she has followed that same underfill/overfill pattern and lost maybe 20kg in 3.5 years. Well, a few months back, she and her surgeon decided to swap her over to a new band, and at the same time as he went in he found a hernia, which he repaired. The weight has fallen off her in the past couple of months, the new band is working brilliantly - what it was we dont know - new placement, hernia repair, new style of band, maybe a combo of all three, but sometimes, there's just something wrong in there.

The sleeve isnt really a common option here yet, the band is getting more and more popular but deciding to be rebanded without having slipped or eroded made all the difference for her.

My point is not that you ought to be rebanded but sitting here feeling like YOU have failed the band isnt really productive and surgical intervention of one sort or another might be your answer. My friend's hernia was not picked up by any testing, till she went in for surgery and it was actually seen.

I'd definitely seek another opionion just to compare notes.

[marlena 0]

I think i will call around the sydney area for surgeons tomorrow and call down the list - maybe book in a few appointments. I think ive lost a little confidence with my surgeon and that i should slink away from him quietly since ive already added to his failure stats...

Im very positive about the sleeve atm - i think the thing i miss most when im restricted is Water and being able to drink it cold - i have not done this since 2004 as it just hurts too much (please tell me this isnt a problem with the sleeve?!)

Thanks Jacqui, i think ive seen u on an aussie support group maybe? im on the market for a new surgeon so if you know of any that do the sleeve or maybe which surgeon ur friend used i would love the details if you dont mind?

Thanks

Marlena

[starrgirrl 0]

Hi Marlena-

I'm not a medical expert on the sleeve or the band, but I'm a former bandster who is also investigating the sleeve. To help with my research, I subscribe to the medical journal, Surgery for Obesity and Related Diseases. As it's a medical journal, the articles are intended for doctors, therefore the language is sometimes hard for me to understand due to all the medical terms. However, it has been very helpful to be able to read about all the studies that are happening regarding WLS. In this month's issue, there is an article about bariatric surgery reducing the cancer risk in morbidly obese patients.

I mention it in case you feel guided to buy the article or get an annual subscription. I paid around $148 U.S. for my subscription and it's been worth every penny. It's allowed me to gain a better understanding of the developments in bariatric surgery.

I figure if I'm going to have pieces of my anatomy removed, I want to learn all I can about the process.

Their web site is www.soard.org

Wishing you well on your journey!

Laurel

[mjacot35 0]

Starrgirl,

What is the reason that you are contemplating the sleve?? Did you not lose well w/the band? When were you banded?

I was banded 9-29-08 and as of today had one fill and only lost 13lbs total. I went up 7lbs after my first fill then back down still total of 13.

My dr told me that the band isn't for everyone and that the sleve could be an option down the road. please respond.

Thanks, Michele

[phillyfawn 0]

It may be different over there, but my surgeon told me that the VSG was the safest WLS and had results that surpass the Band- closer the the RNY w/o the malabsorbtion issues...I had my sleeve a month ago and love it...let me know if you have any other questions.

I think you could benefit from visitng www.obesityhelp.com/forums/vsg

There is a lot of info there, and a lot more people to gather info from. Also, this site has a revision and a complications forum too...knowledge is power...:whatchutalkingabout

[starrgirrl 0]

Hi Michele-

I was banded in 2004 and released about 60 lbs. I was really happy with my weight loss and the band... but about a year ago I started gaining weight because I could eat more... I also started experiencing bad acid reflux. It turned out the my band had slipped and needed to be removed. I had surgery to take it out in July of this year... I've gained back most of the weight I had lost.

I'm not anti-band... but for me, I need to investigate other options. If you click on my name to the left, you can pull up my posts that share more about my jounrey.

Lots of light and success to you!

[marlena 0]

thanks for all ur posts.

i had my first consult with a different surgeon this week and i now remember why i chose my initial surgeon to begin with - the new dr was good but so very arrogant and critical of my other surgeon. he kept looking down at me like i failed my band and somehow it was my surgeons inferior skill or something. it might just be my imagination?

It turns out i have a massive hernia that needs repair and during this surgery i can opt for having the band replaced then and there or removed with a sleeve to be booked in at a later time.

So now comes decision time, do i get a new band and try again or do i skip that part and go the sleeve?

I'm sitting on the fence a little here as 2 surgeons have recomended a 2nd band in preference to the sleeve...

What does everyone think?

cheers

Marlena