Confused

[sandi2004 2]

OK, so sometimes even the health professionals make the wrong choice. This is a very personal matter and a very personal choice. I was advised to have the gastric bypass because I had over 200 lbs to lose, but I have done it with the band. It is all "doable" You must try to look inside yourself and decide what surgery you are most comfortable with. With either surgery your success or failure long term depends on you gaining knowledge and making good choices so either surgery is perfect. Go with your comfort level. The bypass may be easier at first, but at 18 months it is still all about making the right choices to keep the weight off!

I'm 5 years out and i made th eright choice DESPITE what every health professional was advising.

[RestlessMonkey 7]

I think it's always prudent to ask WHY. For example, people who are grazers struggle more with the band.

Her surgeon MAY have a good reason, or it may be knee-jerk. We don't know the OP or the surgeon, so it's hard for us "armchair" players to tell the OP what to do.

[Unforgettable 0]

I would agree with HH to an extent. Obviously you need to feel comfortable with your decision and make sure it's YOUR decision and not entirely based on the opinion of others, but do your research. Ask why your surgeon feels he would recommend the bypass over the band. As previously stated, they are 2 entirely different surgeries and work in 2 entirely different ways. You need to look at your own eating habits and try to figure out what your "problem" is that has got you to the point that you are. For me, it was not about choosing the right foods or eating a lot of junk or sugary foods, I had a hard time with Portion Control. After over a year of research on my own, talking with different health care professionals as well as patients, I decided that the lapband fit my needs. You need to do the same as well.

[BethFromVA 5]

I think it's always prudent to ask WHY. For example, people who are grazers struggle more with the band.

Her surgeon MAY have a good reason, or it may be knee-jerk. We don't know the OP or the surgeon, so it's hard for us "armchair" players to tell the OP what to do.

Which I didn't put all too succinctly. I think, because this is elective surgery, we should be informed of the differences in each surgery, but NOBODY (including us) should ever tell anybody what they SHOULD have done. Any good doctor would provide you with pros and cons of each surgery and let the patient decide what s/he thinks is best for them.

[Nanook 2]

I would agree with HH to an extent. Obviously you need to feel comfortable with your decision and make sure it's YOUR decision and not entirely based on the opinion of others, but do your research. Ask why your surgeon feels he would recommend the bypass over the band. As previously stated, they are 2 entirely different surgeries and work in 2 entirely different ways. You need to look at your own eating habits and try to figure out what your "problem" is that has got you to the point that you are. For me, it was not about choosing the right foods or eating a lot of junk or sugary foods, I had a hard time with Portion Control. After over a year of research on my own, talking with different health care professionals as well as patients, I decided that the lapband fit my needs. You need to do the same as well.

Those points that she made above are the exact types of things that help weed out the right/wrong candidate for any type of wl surgery. I personally could not walk by a "sweet" while I was lap banded without taking a bite or two or three. Now that I've had the bypass I can walk by it and around it and on top of it and not touch it. I was not a large portion person in my eating unless it was a sweet! So there needs to be a realistic way of determining which surgery is right for each person.

Feelings and mainly fear are not good enough reasons to get the lap band, neither is the fact that the band can be removed eventually. Why put yourself through 2 or 3 surgeries if it's not necessary to achieve the same result - weightloss. My main issue has always been finding the right WLS for the right person so extra trauma can be avoided. Nancy.

[BethFromVA 5]

I would agree with HH to an extent. Obviously you need to feel comfortable with your decision and make sure it's YOUR decision and not entirely based on the opinion of others, but do your research. Ask why your surgeon feels he would recommend the bypass over the band. As previously stated, they are 2 entirely different surgeries and work in 2 entirely different ways. You need to look at your own eating habits and try to figure out what your "problem" is that has got you to the point that you are. For me, it was not about choosing the right foods or eating a lot of junk or sugary foods, I had a hard time with Portion Control. After over a year of research on my own, talking with different health care professionals as well as patients, I decided that the lapband fit my needs. You need to do the same as well.

Okay, now this I can get my mind around. It makes sense, as does Nanook's addition to this. It doesn't mean I wholeheartedly fall in lock step with gastric bypass (again, for me), but my issue as well was more about portion control and I can see how the band would help me with that more than going a more drastic route.

I still hope the OP uses her own research skills (including asking the doc and other professionals she has spoken to) WHY they are recommending bypass. That is a great recommendation.

[MacMadame 81]

I have had both of them. The band was WRONG for me, because it didn't address MY particular issue. I had the Bypass, and it DID work.

My understanding is that your band eroded. That isn't a case of picking a procedure that didn't address your eating issues. It was a case of mechanical failure.

Now, if you want to say that the band isn't "less invasive" like it's marketed to be due to your experience, I can see that, but saying it didn't address your issues smacks to me of re-writing history and IMO is misleading.

HERE WE GO AGAIN. HEADHUNTER - STATE YOUR OWN OPINION, GIVE YOUR OWN ADVICE. QUIT QUOTING WHAT OTHER PEOPLE SAY AND UNDERMINING THEIR ADVICE, CHOICES, OPINIONS, ETC. YOU MAY NOT REALIZE IT BUT YOU ARE BEING EXTREMELY RUDE AND I DON'T APPRECIATE IT.

Please leave the moderation to the moderators. It is not against the rules to quote a post that you are directly responding to and there is nothing inherently rude about disagreeing with another poster.

As for the topic of this thread, here is my opinoin:

The job of health professions is to provide their medical expertise so that you make an informed choice and don't make a decision based on fear or misinformation. But medicine is a partnership and your job is to provide the expertise on you. No one else knows you like you do and that's an important part of the equation.

And HH, I completely disagree that it's the job of our surgeons to influence us to pick one surgery over another. Unless you have medical concerns that preclude one surgery or another, they all work. So it comes down to personal preference and which one you think will work the best for you.

There are some surgeons out there who are married to one procedure or another and, gee, everyone who comes to their office is a great candidate for it. Imagine that! :tongue2: When these health professionals recommend a bypass or a band, it's a completely meaningless recommendation because it really has nothing to do with YOU and everything to do with THEM.

But there are other health care professionals who are more balanced and their recommendations mean something.

The trick is to know which you are dealing with and that's where your self-knowledge comes into play. If your NUT and counselor were spot-on in their understanding of your issues, it is well worth it to listen to them. If they are just giving the generic "if you like sweets, you should get a bypass" advice -- which is overly simplistic and not necessarily true for everyone -- then their advice is meaningless.

Edited August 5, 2009 by MacMadame

[BethFromVA 5]

AWESOME, Mac!

[Elisabethsew 50]

Hi all I have had all my appointments and will be seeing the dr for follow up on all my test results next wk thursday. After that I see the surgeon and schedule my surgery. I am now confused, but I do want the band, but been thinking about gastric a lot lateley I even had a dream about it last night. I really don't want gastric becuase of the higher risks and the re routing of my insides. The physcologist and dietician both mad me a lilttle upset when I saw them they both had there comments saying that I should have the gastric and that the surgeon is going to tell me the same thing and blah blah blah. So now I am just confused and scared now that what if the band doesn't work for me. How did you all know it would work for you if you loved food so much? Another thing with te gastric I have too many friends that has had it and are now gaining there weight back and that's another thing I don't like about gastric as well. I mean was it easy with the band to eat better and diet please someone help me I feel like tearing up a lilttle cause im tired of being fat and I wanna have success. Please give me some advice what should I do?

Surgeons have to obtain "informed consent" prior to operating on anyone. If you're confused or have questions, you have not been adequately informed and you needs to find out more information and ask questions.

Once you feel informed about all the options available to you, research the one or two that you are leaning towards. Ask yourself what type of eater you are. Do you eat all day? Do you eat huge portions? Do you crave cakes, candy, ice-cream, etc.? Are you a junk food eater? Do you eat a healthy diet but eat too much healthy food? Also consider how you feel about having a band and port inside your body. It did not bother me but others are freaked out about having a foreign material in their bodies. If that is the case for THEM, the band is not their surgery of choice.

The band and the sleeve (VSG) are both restrictive procedures so they limit the amount of food you can eat. However, if you're a person who loves candy and ice-cream, etc., and grazes on Snacks like this all day, it's VERY easy for those foods to slide right down either of these procedures and you can stop losing and easily gain.

The bypass procedure (RNY) and Duodenal Switch (DS) procedures use restriction AND malabsorption to achieve weight loss. With less than 100 pounds to lose, DS would normally not be a consideration for you. RNY creates restriction of how much food you can eat by creating a small pouch for a stomach. The malabsorption happens by cutting out part of the intestine. This causes less calories of the food you eat to be used by your body. Of course, if you don't follow the post-op eating plan, it is possible to stretch out that new stomach (pouch) over time and gain wieght.

I had the band surgery in early 2006 and it was not a good surgery for me. I had the band removed and, at the same time, revised to VSG (the sleeve). Had this been an option for me when I had the band, I would have gotten VSG then. Bypass would not be a good surgery for me but it might be the perfect one for you. Some people freak out thinking their intestines are going to removed. That is not true. You have small and large intestines that are MANY feet long. Ask your MD/surgeon to SHOW you how much small intestine is removed during surgery. The VSG (sleeve) procedure removes 60-85% of your stomach. That freaks some people out. I look at it like I had a defective stomach that was huge and never allowed me to feel full. Now, I eat small portions of food, feel full, and lose weight.

Decide what type of eater you are USE the advice of the health care professionals to help YOU make the decision on what surgery is best for you.

[Headhunter 6]

“My understanding is that your band eroded. That isn't a case of picking a procedure that didn't address your eating issues. It was a case of mechanical failure.

Now, if you want to say that the band isn't "less invasive" like it's marketed to be due to your experience, I can see that, but saying it didn't address your issues smacks to me of re-writing history and IMO is misleading.”

Then you would be partially wrong. My band failed me because it was the WRONG surgery for me. It simply didn’t do anything. And THEN the mechanical difficulties began. It was given plenty of opportunity to do what it was supposed to do, and it did not. My situation was complicated, and there were a lot of factors involved. But ultimately, the Band was NOT the right choice for me. Restriction was NOT my solution; Malabsorbtion was…and IS.

“smacks”? hardly. It was installed. It didn’t work. Restriction did nothing for me. Then the mechanical problems began AFTER it had been inside me for a considerable time. I had the bypass and it DID work. There's no "re-writing" ......It is what it is.

I have stated quite repeatedly that the OP should LISTEN to their Doctor, and take into consideration what they say.

“But medicine is a partnership and your job is to provide the expertise on you. No one else knows you like you do and that's an important part of the equation.”

It sounded like the OP HAD provided the “expertise on her”, and the Medical Team were making a recommendation. Am I understanding that everyone here is suggesting that you simply IGNORE what the Medical people are saying?

I may be in the minority, but I WANT the Doctors to make recommendations. Nothing says that I have to accept the suggestions, but I’ll sure as hell stand by the notion that ANY responsible Medical Professional SHOULD make a recommendation as to what THEY think should be done, and let the patient make a decision based upon that. If I had cancer, I certainly wouldn’t want the doctor to say “well, you can have chemo or Radiation – you pick”. I would EXPECT them to explain them to me, and make a RECOMMENDATION based upon their years of experience and knowledge about the probable outcome. That’s what I pay my medical people for….their EXPERTISE. And part of that is being able to suggest/recommend the most likely route for success, based upon their EXPERIENCE with people in my situation. I’m not sure why anyone would disagree with that notion……

“And HH, I completely disagree that it's the job of our surgeons to influence us to pick one surgery over another.”

And precisely where did I say that? I did not. Refer to my comments above regarding recommendations based upon expertise. Influencing is a far different concept than recommending or suggesting.

“The job of health professions is to provide their medical expertise so that you make an informed choice and don't make a decision based on fear or misinformation. But medicine is a partnership and your job is to provide the expertise on you. No one else knows you like you do and that's an important part of the equation.”

This is close to what I have been saying. If you’ve done your due diligence in selecting a Surgeon/Team, then you SHOULD be able to trust the recommendations that are given. That doesn’t mean you have to accept them.

“Unless you have medical concerns that preclude one surgery or another, they all work. So it comes down to personal preference and which one you think will work the best for you.”

Not entirely. If your NEED is malabsorbtion, then restriction won’t do jack for you. You may lose a little but, what you DO lose could hardly be called a “success”. I have said here before that “they all work to varying degrees” but to be successful you need to pick the RIGHT one. You do NOT want to do this over again.

“There are some surgeons out there who are married to one procedure or another and, gee, everyone who comes to their office is a great candidate for it. Imagine that! When these health professionals recommend a bypass or a band, it's a completely meaningless recommendation because it really has nothing to do with YOU and everything to do with THEM.”

I’m in total agreement with you here. This is why I continually harp on the idea of choosing the RIGHT Medical team for your procedure. I warn people about the “seminars” that are attended by potential patients. They are often no more than “sales presentations” and need to be regarded as such.

“But there are other health care professionals who are more balanced and their recommendations mean something.”

So what you’re saying is that you SHOULD listen to their recommendations if you trust the Doctor? That is precisely what I am saying.

“The trick is to know which you are dealing with and that's where your self-knowledge comes into play. If your NUT and counselor were spot-on in their understanding of your issues, it is well worth it to listen to them. If they are just giving the generic "if you like sweets, you should get a bypass" advice -- which is overly simplistic and not necessarily true for everyone -- then their advice is meaningless.”

This is yet another example of something I have been saying, again, all along. You need to find the best Surgeon and associated Team. People you can trust. But again: the OP said that both her Psych and Dietician had suggested that Bypass would be appropriate. IF they were correct in their evaluation of the OP, then what they say at least needs to be considered.

“. If your NUT and counselor were spot-on in their understanding of your issues, it is well worth it to listen to them.”

That is what I said.

Bottom line here, folks, is that we agree here on MOST points. If anyone was thinking that I am suggesting that the OP simply shut up and do exactly what the Doctor says, that is totally wrong. I began my part in this discussion because someone here suggested that the OP ignore what the Medical Team was saying, and do what she wants. I think that is wrong, no matter how you look at it. If you’re not going to listen to the Medical Team you have chosen, then you shouldn’t have chosen THAT Medical Team.

HH

[Headhunter 6]

Surgeons have to obtain "informed consent" prior to operating on anyone. If you're confused or have questions, you have not been adequately informed and you needs to find out more information and ask questions.

Once you feel informed about all the options available to you, research the one or two that you are leaning towards. Ask yourself what type of eater you are. Do you eat all day? Do you eat huge portions? Do you crave cakes, candy, ice-cream, etc.? Are you a junk food eater? Do you eat a healthy diet but eat too much healthy food? Also consider how you feel about having a band and port inside your body. It did not bother me but others are freaked out about having a foreign material in their bodies. If that is the case for THEM, the band is not their surgery of choice.

The band and the sleeve (VSG) are both restrictive procedures so they limit the amount of food you can eat. However, if you're a person who loves candy and ice-cream, etc., and grazes on Snacks like this all day, it's VERY easy for those foods to slide right down either of these procedures and you can stop losing and easily gain.

The bypass procedure (RNY) and Duodenal Switch (DS) procedures use restriction AND malabsorption to achieve weight loss. With less than 100 pounds to lose, DS would normally not be a consideration for you. RNY creates restriction of how much food you can eat by creating a small pouch for a stomach. The malabsorption happens by cutting out part of the intestine. This causes less calories of the food you eat to be used by your body. Of course, if you don't follow the post-op eating plan, it is possible to stretch out that new stomach (pouch) over time and gain wieght.

I had the band surgery in early 2006 and it was not a good surgery for me. I had the band removed and, at the same time, revised to VSG (the sleeve). Had this been an option for me when I had the band, I would have gotten VSG then. Bypass would not be a good surgery for me but it might be the perfect one for you. Some people freak out thinking their intestines are going to removed. That is not true. You have small and large intestines that are MANY feet long. Ask your MD/surgeon to SHOW you how much small intestine is removed during surgery. The VSG (sleeve) procedure removes 60-85% of your stomach. That freaks some people out. I look at it like I had a defective stomach that was huge and never allowed me to feel full. Now, I eat small portions of food, feel full, and lose weight.

Decide what type of eater you are USE the advice of the health care professionals to help YOU make the decision on what surgery is best for you.

Elisabeth;

Very well-put all the way around. I agree.

HH

[RestlessMonkey 7]

HH if there's one thing I "know" about you, it's that you NEVER advocate blindly listening to anyone...even if they have a string of letters after their names.

I think I pretty much said what you did; I just said it Monkey-style. In the final analysis, the OP will do whatever s/he thinks is best, and that's as it should be....you live, you learn. :ohmy:

[Headhunter 6]

HH if there's one thing I "know" about you, it's that you NEVER advocate blindly listening to anyone...even if they have a string of letters after their names.

I think I pretty much said what you did; I just said it Monkey-style. In the final analysis, the OP will do whatever s/he thinks is best, and that's as it should be....you live, you learn.

Oh, you are SO correct. One of the elements of my story is that I put a lot of trust in someone that I should not have. I am SO skeptical of Doctors. If you think I'm a little "in your face" on THIS forum, you should see them cringe whenever I go into our Medical Center here!:ohmy:

What I want to emphasize is that you CAN trust SOME Medical People. You just have to do the work to be able to find out WHO they are. And if you DO the work, and you have confidence in them, then by all means, listen to them. It seems that some people here took "listen" to mean "obey". That is not the case.

And about your story of the Dentist.....I have a GREAT dentist who I Trust totally. I'm trusting him to do some work on me over the next couple of weeks. I'm trusting him to the tune of $17,000.

HH

[Headhunter 6]

I think I pretty much said what you did; I just said it Monkey-style.

I'm beginning to think that Monkey-Style is far more preferable to my own. :ohmy:

HH

[BethFromVA 5]

Oh, you are SO correct. One of the elements of my story is that I put a lot of trust in someone that I should not have. I am SO skeptical of Doctors. If you think I'm a little "in your face" on THIS forum, you should see them cringe whenever I go into our Medical Center here!:ohmy:

What I want to emphasize is that you CAN trust SOME Medical People. You just have to do the work to be able to find out WHO they are. And if you DO the work, and you have confidence in them, then by all means, listen to them. It seems that some people here took "listen" to mean "obey". That is not the case.

I think I was partially guilty of that, and I apologize. Though we have exchanged ideas and are very much on the same page in certain things, I have to admit that I don't know your story. Is it listed here somewhere so I can catch up?

I have seen others here really shove their thoughts down the throats of others who are confused, and not saying that I thought you were doing that, but after reading EVERYthing from EVERYbody, I got a fuller understanding of why a certain procedure might be recommended, how each one has its differences that may work for or against the patient, and that sometimes I read more into what's being said than I should. I took it that the doctor and the psych and nutritionist were all just blankly saying bypass. I'm sure there's more to it (or at least I HOPE there is).

All I hope is that the OP isn't even more confused and that maybe this thread armed her with some good questions to ask her doctor so that she can make the most informed decision she can for herself.