Surgeon wants to revise me from LB to VSG, HELP - ThinnerTimes - Gastric Bypass Forum, Lap Band Forum, and Vertical Sleeve Gastrectomy Forum

LavenderRose · 07-08-2008, 07:11 AM

I am so frustrated that I had LB surgery, only for it not to be compatible for me. I have RA & fibromyalgia and my surgeon recommends that I get the sleeve. I will have to do 6 month supervised diet and see the psch doc again, so my insurance will pay for the revsion. I am only nerevous about the surgery because it is restrictive only again. I don't understand what makes him think the sleeve will work if the band didn't. Can any of you folks who have the sleeve expalin to me why you think I will lose with the sleeve if I didn't with the LB?

He wouldn't give me a fill because he is afraid it will become too tight and I will just need an unfill. He doesn't recommend gastric bypass because I have RA meds to take. But I can't take anti-inflammatories much because I am allergic to them. I di currently take pain meds my mouth and I give myslef Enbrel injections for the RA. I would prefer VSG over GB if I could lose the weight and become a healthier person. My fear is having another surgery that won't work for me. I want a tool that will work with me, you know what I mean? I don't expect it to do ALL the work, but I need help. I didn't get any help from the LB.

Please explain to me how the VSG can help me better and how it has made YOU lose weight. Thank you.

I just want to cry over all this and could really use some support and understanding. I feel so alone.

kellyMASS · 07-08-2008, 08:48 AM

If you think you need more than just the restriction look into the duodenal switch. It is basically a vsg with malabsorbtion. I have a full description af why I picked the ds in my personal story."Kellys story"
Good luck on whatever you choose.

tropigal · 07-08-2008, 02:30 PM

Don't feel alone, we're here for ya!! I'd be more able to address your question of how the vsg can help you when the band didn't if you told us a little more. Why didn't the band work for you? Are you still eating too much? If so, are you eating to much because your band isn't giving you enough restriction or are you eating around your band? By that I mean are you constantly eating small amounts all day and therefore bypassing the restrictive qualities of it?

If you are eating around your band then you will be able to do the same thing with a sleeve. If you constantly graze all day, try to find ways to get things in and eat the wrong things you will not lose with it.

Where the sleeve has an advantage over the band is that with the sleeve you will be able to feel satisfied with 3 meals and a snack or two. I've heard bandsters say that even though the restricted part of the stomach was full the rest of their stomach was telling them it was hungry. But you will have to fight the old habits and head hunger just like with any wls.

I can say that one of the pluses of the sleeve is that there is usually a reduction in grehlin, the hunger hormone produced by the stomach and gut. Since a portion of the stomach is removed it's not there to produce it so you feel less hungry.

That's my honest opinion. Tell us more and maybe I can tell you more.

LavenderRose · 07-08-2008, 04:29 PM

Hi Pamela,

Your question of why the band didn't work for me. I have RA and the inflammation would make my band too tight, therefore, I would need an unfill, but then I would be too loose. The surgeon could never get me to that 'sweet spot'. I only eat 3 small meals a day w/ 1 snack. I do not graze...never really have. I eat the 'right' foods 85 % of the time. I do eat some bad foods here and there...I am human, but I don't eat them all the time. I am currently working with a counselor on head hunger and working to eating the right/heathly foods 90-95% of the time. I am also getting ready to work with a nutrtionist for my 6 month supervised diet so I can have the gastric sleeve and have my insurance pay for it.

When my band was on the tighter side I would get chest pain and couldn't eat no more then 2-3 small bites of something with chewing very well and then I couldn't eat anymore and my lower tummy was saying 'feed me' I was starving. Then I would eat softer high calorie foods to get my lower belly full. So I can relate to what a lot of other banders felt on that part. I would love to not feel hungry. I feel the band messed up my metabolism even more then before. It put me in starvation mode and then when I would have it unfilled my body stored what I did eat, even if it wasn't a lot.

You said the Hormone Ghrelin is removed, but will it adventually come back in time...like 2-3 years after surgery and make you feel hungry again? I do understand I will have to work very hard with any WLS and I did work very hard with my band. My surgeon felt so bad for me because I worked so hard and when I was hit bad with my body attackig itself (RA=auto-immune disease) I was in so much pain and stiffness I thought I would end up in a wheel chair. But I have been fighting and I started a med called Enbrel for the RA 6 weeks ago. It takes up to 3 months to work. I also am on pain meds that are being watched very closely. I push myself as much as I can, but don't go too far or I will end up bed ridden and that will not help me or my weight loss at all.

I am looking for a TOOL that will help me along the way with all my work I do. I want a team effort here. But if the sleeve won't do anymore for me then the band I won't have that surgery. The point of me having surgery was for assistance...not a miracle bullet...but a tool to help me along. The LB did nothing for me.

For the next 6 months I will be working with my counselor on the food issues/head hunger and will see a nutritionist to help me with planning meals. I will be exercising and doing what my doc and pain management specialist wants me to do as far as exercise is concerned. I just ordered a leg magic for leg and thigh exercise and I walk. I also do walk away the pounds dvd and have a total gym. Like I said I want a tool/wls that will work with me not against me or be for nothing. I don't particulary like being cut on or have any body organs removed for nothing. That is why I am researching this and seeing what has happend for others before jumping into this.

Thank you so much for your response and all your help. I deeply appreciate all the support and information I can get. It is hard finding people who had VSG.

Here are some questions I have that maybe you can help me with:

When did you get your sleeve done and how much have you lost?

What does the pre-op and post-op diet consist of?

How long does it take to recover? ...drive a car...go to grocery store etc,
How much after care will I need at home after surgery and for how long? My husband works 5-6 days a week, 12 hour days.

How long is the window of opportunity for you to lose weight with the sleeve? 6 months, one year...always?

Anything else you want to add in there you think I should know would be welcomed also.

I look forward to getting to know you and all the VSG peeps.

tropigal · 07-08-2008, 09:08 PM

Quote:

Originally Posted by LavenderRose

Thank you so much for your response and all your help. I deeply appreciate all the support and information I can get. It is hard finding people who had VSG.

Here are some questions I have that maybe you can help me with:

When did you get your sleeve done and how much have you lost?

What does the pre-op and post-op diet consist of?

How long does it take to recover? ...drive a car...go to grocery store etc,
How much after care will I need at home after surgery and for how long? My husband works 5-6 days a week, 12 hour days.

How long is the window of opportunity for you to lose weight with the sleeve? 6 months, one year...always?

Anything else you want to add in there you think I should know would be welcomed also.

I look forward to getting to know you and all the VSG peeps.

You poor thing, you've had such a hard time. I hope the VSG is an answer for you. I hope you didn't take my post wrong, I wasn't accusing you of missusing your band. But I didn't want to just jump in and say you'll love the VSG without knowing the whole story of why the band failed for you.

Let's see if I can answer your questions. The part of your stomach that produces grehlin is long gone, never coming back

so the production of grehlin doesn't come back. BUT people report different levels of hunger abatement. The gut produces it too, so there is still some in your system. But I don't think I know anyone who says they aren't less hungry than they were before surgery. It does take a while after surgery for your hunger to lessen while the hormone in your system works its way out. Sometimes up to a month.

My sleeve was done 9/13/2007 so 10 months ago. I've lost 90 something pounds (I only weigh occasionally, last time was 92) and have about 20 to go. I was cash pay and it cost $12,000 for everything.

Let's see, recovery, it's similar to any lap procedure. Probably similar to your band. I had surgery on Thur stayed in hospital one night and went back to the hotel. I traveled 6 hrs to have it done. My reservations were through Sunday but I felt good enough for the ride home on Saturday so we left. No driving until you're off pain pills, I didn't take any after the first day home. I was really tired the first week but otherwise felt OK. I didn't need any care that I couldn't give myself during that time. I would say I was feeling normal in 10 days. There was a limit on lifting for a while, don't remember exactly how long that was.

Pre-op and post-op diets vary widely by doctor. Some require a liquid diet for 2 weeks prior and some only require 24 hrs for pre-op. Post-op almost all require 1 week clear liquids after surgery but from there it really varies how fast they reintroduce foods. Your doctor's nutritionist can tell you what he recommends.

There's a golden window of about 6 months with any wls, for the first few months while your stomach is healing you can't eat much no matter what you do. This means you will loose the most then. But the VSG is good for long term loss as the way out stomachs are reduced they tend to be less stretchy. There's not as much chance of us making it big enough to eat large meals. The loss kind of settles into a slow and steady pattern which is where I am now.

I think I answered your quesitons, if not ask again. I've talked to a lot of vsgers on a larger VSG forum elsewhere so I think I'm pretty typical in my experience. If you haven't done so, check out my blog for more info, it's in my signature.

Good luck to you!!

LavenderRose · 07-09-2008, 07:33 AM

Pamela,

Yes, you did answe all my questions...thank you so much!

I know you were just trying to see what was up with my band and if I was following the rules so you could help me more with knowing if the sleeve would work for me. I am just so frustrated and disappointed over all the work I did with the band that I may come accross irritable in my post...sorry if it seemed that way. That is the hard part about typed words, is we can't hear the tone in anothers voice that makes us hear how they feel about what they are saying.

You are so kind to take the time to explain all that to me and I can't tell you hope much that means to me. I am at a point that I am confused and don't know if to turn right or make a left.

From what you said, I think the sleeve is right for me and will help me with my weight loss and be a tool I can use and that will help me while I do MY part as well. I was so frustrated with the band that I did MY part and that darn thing was just a piece of plastic laying around doing nothing, like a renter who won't pay his/her rent...

You have done a GREAT job losing weight. I did sign on to your blog, but my darn computer kept freezing up after I went there. I don't know why. I was able to read the whole page though. I like your snack choices and I wrote them down. I LOVE southbeaches Banana and strawberry flavore pcks for water. The Tropical breeze was at my grocery store when I got the other flavor and when I went back to get the Tropical breeze they didn't have it and I haven't seen it since. I am going to ask customer service if they can order it again. I haven't seen it any of my other stores around either. Some place don't carry southbeach flavored packets at all. This makes me so made! I like them better than crytal light.

Take care and keep up the awesome work with your weight loss. Again, thank you for sharing all your knowledge with me and for your kndness.

kesleea1 · 08-05-2008, 11:15 AM

Check out the VSG forum on Obesityhelp.com...there is a lot of VSG help to be found there.

I had it done 5/15/08 and have lost 59 lbs so far. It is the best thing I ever did for myself and I still have to lose over 100 lbs more.

Try MSM for the RA; it is all natural and there is no risk of damaging your liver. I think it is safe to take up to 6k mg. It works. It helped me a lot. I don't use near as much as I use to.

SueRN · 08-27-2008, 05:57 AM

You've really been thru a lot. You may want to see another bariatric surgeon, who is certified as a center of excellence, just to get a second opinion. Since you have other medical conditions that will affect the process and the outcome, it wouldn't hurt. The only thing I know about the gastric sleeve is that most times it's used because for certain reasons, a full gastric bypass surgery either RNY or DS cannot be done at the time. It will help the person to lose some weight until it is safe to convert. Not many people get it as the only procedure. Also, most insurance companies will not cover this procedure as it is considered investigational (which means there hasn't been enough proven outcomes to show it's as effective as RNY, DS, LB, etc). Has your surgeon consulted with your RA doctor? If not, that would be another thing you may want to look into. It never hurts to get a second opinion. Good luck to you. Sue

LavenderRose · 08-27-2008, 10:22 AM

Hi Sue,

My surgeon is certified as a center of excellece and has been in magaizines and is very high up there on experience and he is an excellent doctor. I trust him completely. I have talked with my RA doc and she is all for the revision and feels the sleeve would be best for me. My surgeon and my RA and primary care doc have all consulted about this process. I wouldn't have it any other way. After all this is my body we are talking about.

It shocks me if you are an RN and you don't know that the sleeve is now being done as a only procedure now, not just a first step before a RNY or the DS. Also, many are getting this as a only procedure and the sleeve is becoming very popular with the bariatric surgeons. It is a less drastic step as opposed to the RNY and DS, which a lot of people with lower BMI's are attracted to when they don't want the band, the RNY, or the DS. I am one of those people. I did get the band hoping that would do the trick for my weight loss and assist me in my part of the battle, but wasn't one of the lucky ones with the band. Are you a bariatric RN?

I know there is little long term results, but 5 years is a good amount and so far a lot of people seem to do well with the sleeve from what I have read so far. Also, partial stomach removal has been done for many years on patients with cancer or ulcers, and they have done well after the procedure.The reason I am choosing this surgery is that I am not comfortable with the re-routing aspect of the RNY and DS. The sleeve appears to have less complications compared to the rest of the procedures.

At this point, I have only read positive results and reading people saying they are so happy with their sleeve. I have looked for people to say they hate their sleeve or they wish they never got it, or something negative. I keep searching for someone to say, "Don't get the sleeve" after they have gotten it, but I can't seem to find anyone saying this no matter how much I look for it. I can't even find complications yet on the boards about the sleeve. The biggest complaint I am seeing is constipation after surgery, which is most likely from the pain meds and shock from surgery on the body.

Yes, the surgery is still investigational and insurance companies are not approving many people to get this procedure. I was told my insurance will pay, but I needed a 6 month supervised diet and doctors to advocate why it would be best for me to get this revision and the particulare surgery. Then the surgeons office can work with my insurance to approve it. I am hoping there will be no problems.

I am currently working with my primary care doc, my RA doc, my dietician, the bariatric nurse in my surgeons office, and my surgeon on my weight loss surgery and my other health issues. I am also, working with a counselor on my relationship with food. I am doing the right things, now I can only hope it pays off.

Thanks Sue, for the concern with my health issues and the weight loss surgery.

LavenderRose · 08-27-2008, 10:27 AM

Kesleea,

You have done a GREAT job of losing your weight. Almost 60 pound in 3 months. That is awesome. Keep up the great work!!!

I may have to go to the library or get on a computer at the library to go to obesityhelp. My computer freezes up on that site and only that site.