f@tLASS

Severly OBese BMI 71... Is the Band for ME?

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I'm 6 feet tall, 515 lbs... actually thats where i was when i decided i needed to do something... im very active, and my weight doesnt seem to slow me down unless it comes to wanting to ride the rides at the carnivals with my fiance... anyway...lol im currently at 490 and thats just 7 days of using the bariatric advantage meal replacement, soup at dinner and swimming during the week for an hour, and walking during the weekends for an hour... i wish i had the will power to just keep doing something like this instead of going through surgery, but i know i'll just end up eating whatever, drinking whatever and living life continueing to get larger... but at my size... is the band really the right choice?? im scheduled for surgery august 23rd.. maybe im just getting cold feet.. honestly im scared to get surgery.. ive never had any medical issues in my life... so this is th first time in the hospital or anything... maybe its just the cold feet... thoughts anyone???

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It's a choice only you can make and there are many things to consider.

Personally, the band wasn't an option for me given my history of grazing. I know that I wouldn't have had the discipline to rely solely on the restriction. And truthfully, I wouldn't have wanted to deal with the whole fill thing.

In your situation, I'd be looking seriously at the vertical sleeve gastrectomy (VSG). It originally started out as the first in a two step procedure with patients with a high BMI. It gives the restriction with none of the potential for malabsorption of vitamins and minerals that can come with the RNY.

Certain patients may have a body shape that makes their surgery more technically difficult. For example, patients with a BMI over 60 -- particularly those who carry their weight in their belly area -- may be at increased risk for bariatric surgery. If you fall into this category, you may benefit from a 2-Stage bariatric surgery.

In the staged approach, a multi-step operation like the gastric bypass or the duodenal switch is broken down into 2 simpler and safer operations. In the first stage, a sleeve gastrectomy is performed. This allows to lose 80 to 100 pounds or more, which will make the second part of the operation substantially safer.

The second stage operation is usually performed 8 to 12 months after the first. The "sleeve" stomach is converted into a formal gastric bypass or duodenal switch. This will permit additional weight loss and will provide a much more permanent result than sleeve gastrectomy alone.

Both stages of the surgery can be performed laparoscopically, giving the advantage of shorter recovery, shorter incisions, fewer incision-related problems and less pain.

But some patients were so successful with the sleeve that they didn't need to go on and have their VSG converted to a RNY - the VSG has proven an excellent stand-alone WLS.

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I have to say that I was very much like you. I was extremely healthy and my primary called me "the healthiest fat guy he ever met". Lets just say that didn't help me when it came to losing weight. I could walk fine, i was work horse with a lot of energy. It took me a couple years to finally decide to take on the surgical angle. Ultimately it was time for me. I was tired of being the spectacle and and embarrassment to my children. I wanted to live and I knew that if I kept going I maybe had a few more good years before the problems would start creeping. But like Cinwa said, this is only a decision you can make and your head needs to be in it to achieve success. I wish you the best success whatever the direction you choose. I think opening up and saying that you are scared is perfectly natural and a great first step... we were all scared at some point. Now overcome that fear and move forward! You can do this!

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My hubby had right around 200lbs to lose and our bariatric surgeon didn't even consider the band. He actually recommended the vertical sleeve but at that time our insurance wouldn't cover that. Hubby ended up having the RNY gastric bypass, no complications, and met his goal and has been able to maintain it fine for almost 2 years. His health is 100% better, and that's what influenced my decision to have an RNY with the same surgeon 6 weeks ago - so far so good!

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I have a friend who lives next door and she is struggling really hard to loose 80 lbs with a band and she is 2 years out post op. I have another firend who had 100 lbs to loose and only lost half with the band and then gained 70 lbs back.I really don't think the band was intented for those who have more than say 100 - 150 lbs to loose. I would say have a long talk with your surgeon and take a long hard look at tha data regarding effectiveness of band vs. bypass or sleeve. One of the first and most inportant stats I would research is the number of band to bypass or sleeve revisions and the reason for the revision. I have a sleeve and I had 80 lbs. to loose and I didn't even consider the band. But in the end it is the decision for you and your surgeon to make. Best of luck to you and I hope that you find peace with your decision.I just beg you to do something because just because you are healthy and active now doesn't mean that forune will continue. Please do something. Love, best wishes and encouragement for you.

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Your progress so far, with making the lifestyle changes is phenomenal! It's amazing to see what people do when they make up their minds that their time is NOW. I applaud you for still wanting to go ahead with the surgery....I'm afraid the statistics aren't that great long-term for people who have lost a tremendous amount of weight without the surgery. I spoke with my PCP and my surgeon about this after I had lost 130 lbs over several years before I considered the RNY. I ended up stalling out FOR 3 YEARS (not kidding) while exercising, maintaining my low calorie life, and taking truckloads of supplements and weight loss medication (final attempt at getting out of stall). And, I never had a comorbidity other than PCOS.

I had to choose between doing something drastic to try to get down to a normal BMI or be happy with the 250-275lb range. I went for the RNY for a couple of reasons: I was deathly afraid of paying out of pocket for a revision down the road and I wanted the "dumping" motivation that went with the bypass. Well, and leaving a piece of medical equipment behind was NOT for me! During my first consultation, my surgeon asked which surgery I was leaning toward. When I said RNY, he said, "good, given your highest weight, we don't want to take any chances." Talk to your surgeon. He/she already has a recommendation in mind.

Good luck to you. Can't wait to see how you do in the future. Your username is great, btw....thanks for the giggle.

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Man... thanks for the replies.. this is awesome... I honestly didnt expect to see much of any replies, or at least not this rearly.. i wasnt even gonna log on but so glad i did.....

i am kinda scared to move forward with the band...specially after some of these.. the surgeon and I did talk quite a bit and only at one point did she mention the sleeve... and when i told her i was pretty scared of being cut, she shrugged it off and we continued with the band... so i guess she felt comfortable with the BMI... I dunno.. now im second guessing it..

Cinwa... where did you get that quote... i want to read more on that... this may help my decision...?? what do you mean grazing?

esob... your right... thats exactly how I felt.. i mean the diabetes, or whatever would of had to of shown up sometime... Thanks...

shrinkingturtle... where can i find this data you speak of.. i google band vs sleeve.. and i seem to get alot of ads... like i want to see an actual study, or actual stats,... where did you find these?

nestingdoll... LOL thanks, on my phone i would track my calories, and excercise i called it operation F@tLASS .. lol half fat loss, half fat butt... i thought it was coo... plus im alwasy joking, and i alwasy have everyone around me laughing so this fits my personility to the T..... thanks for your response, but what is the "dumping" motivation that you speak of? what is RNY?

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I have to agree with all the above....a decision only you can make. That said, the 'average' band patient loses 50% of their excess weight, the 'average' bypass patient loses 80%, the sleeve is somewhere in between. I say 'average' because what you do yourself will make you average or above or below. As a recently unbanded lap band patient, I would lean towards the others solely based on my complication (slippage, gastric herniation, etc). The band works for many without problem but there are also a lot of us out here who had complications....I know several surgeons who will only band with a BMI up to 45 or 50 simply because the weight loss isn't typically as dramatic. Harass your doc for more information, I hate that they dropped the bypass discussion so easily, I feel like they should have laid all the facts on all 3 surgeries out for you, whether you wanted to hear it or not, so you were at least making a semi-educated choice as opposed to the mor emotional 'no cutting!!!' choice.

That said, you're doing awesome, keep up the gre work and keep us updated!!!!!

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Man... thanks for the replies.. this is awesome... I honestly didnt expect to see much of any replies, or at least not this rearly.. i wasnt even gonna log on but so glad i did.....

i am kinda scared to move forward with the band...specially after some of these.. the surgeon and I did talk quite a bit and only at one point did she mention the sleeve... and when i told her i was pretty scared of being cut, she shrugged it off and we continued with the band... so i guess she felt comfortable with the BMI... I dunno.. now im second guessing it..

Cinwa... where did you get that quote... i want to read more on that... this may help my decision...?? what do you mean grazing?

esob... your right... thats exactly how I felt.. i mean the diabetes, or whatever would of had to of shown up sometime... Thanks...

shrinkingturtle... where can i find this data you speak of.. i google band vs sleeve.. and i seem to get alot of ads... like i want to see an actual study, or actual stats,... where did you find these?

nestingdoll... LOL thanks, on my phone i would track my calories, and excercise i called it operation F@tLASS .. lol half fat loss, half fat ... i thought it was coo... plus im alwasy joking, and i alwasy have everyone around me laughing so this fits my personility to the T..... thanks for your response, but what is the "dumping" motivation that you speak of? what is RNY?

Take a look at this website.: http://www.bariatric-surgery-source.com/lap-band-vs-gastric-bypass.html

I also got most of my details regarding the stats from a bariactric center near my home when I attended one fo their info seminars. Soccermom has her numbers very accurate as to what I learned in the seminar. Here is the link to to online seminar that my surgeon has on his website. http://www.baybariatrics.com/ I hope this helps.

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When I first went in, it was to request the band. My surgeon said he did not recommend band to patients with more than 50 pounds to lose. It took me a while to come around to there being other options as that isn't what I walked in there to discuss. I spent a great deal of time researching the alternatives. Ultimately, I chose bypass. As others have noted, only you can make the best decision for you.

Edited by Aunt Beck

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Like cinwa, a gastric sleeve wasn't available to me (insurance), so with 140 pounds to lose, I chose bypass and never looked back. Good luck with your decision! RNY was the best thing I ever did for myself!

Nancy

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I was very much in your situation and had similar thoughts. I was 5'9" and 498 at my heaviest. I was 439 when I started looking at surgery. Initially I wanted to pursue lap band because I felt it was less drastic and didn't seem as extreme.

Every doctor I spoke to told me for people as severely overweight as I was, they only recommend gastric bypass. Each of them used the term "gold standard" in describing it as the most effective tool for weight loss and long-term maintenance and keeping the weight off. I was reluctant to cut up my body the way the surgery does, but ultimately I put on my big boy pants and went for it. I realized I had to get out of my own way.

This was the only surgery I've ever had, the only time I'd ever been in a hospital aside from visiting someone, and the only time I've ever really, truly, done something just for me.

I have absolutely not one single regret. This has been the single most life changing and important thing I have ever done and I live every day happy and looking forward to things instead of living under the crushing bulk of my own weight and living like a hermit out of shame.

Only you can decide what's appropriate and comfortable for you. In my case, I'm glad I had sound medical advice and chose to rely on their expertise.

One other thing.....there is no such thing as will power. Fat is a huge endocrine organ and fights tooth and nail to maintain itself. It's the major reason diets fail....fat has hormones at its disposal and controls you like a puppet. RNY surgery nips that in the bud and allows you to do what you need to do instead of having hunger hormones sabotaging your every move. Good luck!

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I was very much in your situation and had similar thoughts. I was 5'9" and 498 at my heaviest. I was 439 when I started looking at surgery. Initially I wanted to pursue lap band because I felt it was less drastic and didn't seem as extreme.

Every doctor I spoke to told me for people as severely overweight as I was, they only recommend gastric bypass. Each of them used the term "gold standard" in describing it as the most effective tool for weight loss and long-term maintenance and keeping the weight off. I was reluctant to cut up my body the way the surgery does, but ultimately I put on my big boy pants and went for it. I realized I had to get out of my own way.

This was the only surgery I've ever had, the only time I'd ever been in a hospital aside from visiting someone, and the only time I've ever really, truly, done something just for me.

I have absolutely not one single regret. This has been the single most life changing and important thing I have ever done and I live every day happy and looking forward to things instead of living under the crushing bulk of my own weight and living like a hermit out of shame.

Only you can decide what's appropriate and comfortable for you. In my case, I'm glad I had sound medical advice and chose to rely on their expertise.

One other thing.....there is no such thing as will power. Fat is a huge endocrine organ and fights tooth and nail to maintain itself. It's the major reason diets fail....fat has hormones at its disposal and controls you like a puppet. RNY surgery nips that in the bud and allows you to do what you need to do instead of having hunger hormones sabotaging your every move. Good luck!

Well said Mussaka

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Man... thanks for the replies.. this is awesome... I honestly didnt expect to see much of any replies, or at least not this rearly.. i wasnt even gonna log on but so glad i did.....

...........

Cinwa... where did you get that quote... i want to read more on that... this may help my decision...?? what do you mean grazing?

.........

It's all over the internet - this is one but if you copy and past the first few words, it'll bring it up: http://www.lapbandinformation.com/surgery_gastricsleeve.shtml

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I made a decesion.... I went with the Sleeve. Surgery was Tuesday January 15th, 2013.... Almost a week on... WOW i cant believe i went through with it... lets see what happens...

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Congrats good for you... :)

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I am so happy I have the lapband. It has changed my life. I started with a 54" waist and am now 32"

The only food I cannot eat are rice and apple skins and no carbonated beverages.

There have been no side effects and I found losing the weight very easy and I have found maintenance VERY easy.

If I had to do it all over again I would pick the lapband again. I know several people that have had gastric bypass that have now been banded... I guess it's a personal choice between you and your doctor. I personally know of 2 people that got very sick from gastric bypass so that's why I went with the lapband. I'm sure that are good and bad with all WLS procedures but for me the lapband saved my life.

Tom, Toronto

Banded July 6 06

Wt. Loss: 156 lbs

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The sleeve has an outstanding record of success as a stand-alone process but there is the option of revising to a RNY or a DS if needed.

But you're right - it is a personal choice but in our OP's shoes, I think that with a starting BMI 71 (super-mega-morbidly obese), I would have gone with the sleeve too.

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Congratulations! I had bypass, but I have heard nothing but praise from those who went with the sleeve. I know you will be very successful. I'm glad you updated us!

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I made a decesion.... I went with the Sleeve. Surgery was Tuesday January 15th, 2013.... Almost a week on... WOW i cant believe i went through with it... lets see what happens...

Congratulations on your new journey! and welcome to the loser's bench, because that is where you are:)

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Super mega morbidly huh ... Whoa

The sleeve has an outstanding record of success as a stand-alone process but there is the option of revising to a RNY or a DS if needed.

But you're right - it is a personal choice but in our OP's shoes, I think that with a starting BMI 71 (super-mega-morbidly obese), I would have gone with the sleeve too.

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You'll be out of that category soon!

Good luck!

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