mariem

That's what I was told too. My surgeon sat down with me and had a heart to heart talk with me and said that if I were the "average" lap band patient I would lose 50% of my unwanted weight. He showed me a chart and showed me that it would still put in the "obese" catagory and asked me if I was only an average bandster would I be happy with still being obese.

That is when I decided that Gastric Bypass was for me. I am 10 months out now, have lost 130 pounds and 10 more to go till goal.

I have had my RNY since 1-8-09 I noticed straight off the dramatic difference in my appetite and just not wanting food at all.

The past couple of weeks I have been under a lot of stress. I found myself thinking I was hungry and wanted more food (never sugar though, that part has changed for good) When I really analysed my "hunger" I was able to figure out I really wasnt hungry at all, it was head hunger. Something I probably could've never recognized before surgery. I actually upped my intake of Water and the head hunger went away.

We have years and years of doing things by habit. At least I am rational enough now when it comes to food to recognize when I truly do need to eat and when it's time for me to figure out there are more contructive ways to deal with things other than eating.

At first I had the anxiety over the digestive tract being re-arranged, and was also persuaded by the reversibility of the band. But I have been shopping my surgeon and going to the seminars. After listening to them I am concluded that reversibility is a less desirable feature. The crowds always asks about reversibility and surgeons inevitably respond by discouraging that sort of thing with lectures about the lifelong commitment and how reversing even a lap band can lead to complications.

I no longer feel that either option of the band or a bypass is clearly preferable. But after listening to the seminars I am going to discount reversibility in my decision. There are still a lot of factors for me to consider. Both options have their drawbacks.

You know what else I realized. The insurance told me to go to at least one seminar as part of becoming educated about bariatric surgery, even though you can get all this information on line. And while the doctors play along with the “education” line by making you take a test over the material, the seminar is really a sales presentation. It is an infomercial! They go on and on about how wonderful they feel about their work and then talk up the risks of not having surgery, because everyone has that anxiety over the digestive tract being re-arranged. It made me I realize that the seminar is not primarily educational rather it is persuasive communication. The experience is just like listening to someone sell insurance or time shares.

I went to 4 weight loss seminars from 4 different surgeons. 3 of those felt like an infomercial and it made me discredit those surgeons. I felt like they were on a hard sell for patients.

The first one would only do band surgery and would not talk about RNY at all. He just discredited it as the evil surgery.

The last one was the surgeon I actually choose. He let us ask a lot of the hard questions. He did all of the WLS surgeries and was very knowledgeable. He didn't make us feel as if we were on a hard sale. In fact before I was even scheduled to see him for the first visit I was asked if I attended the WLS seminar. I told them yes. They wanted the date to verify it. They said it was part of the puzzle piece for the surgery that had to be done.

I don't recall whether he specified, but I *think* it was a combination of both in-op and post-op events.

In any event, compared to the mortality rates from obesity, I would argue that surgery is the *safest* of the two options for the people who aren't able to manage their weight independently. Yes, it's possible to die on the operating table, but if your health was such that you were already dying -- or living as if you were -- what's the additional risk when the result could be a greatly improved lifespan and the ability to enjoy it?

The mortality rates are going to vary by both surgeon and patient, anyway, so seek out the surgeons at the top of the curve, and do what you can to make their work easier and more efficient (like being aggressive during pre-op). It can only improve the odds of a successful outcome.

I couldnt agree with you more. If you are going to have ANY surgery go in there knowing your options, and especially choosing a surgeon who is on the top of the curve.

Frankly, I dont like surgery and wanted to limit the risks as much as possible. I had 180 lbs to lose and I'm down 172 - I'm 8 lbs from goal so obviously the band was the right choice for me :thumbup:

Yes, it was the right choice for you and for others too. But there are other options out there for those who it's not for. That's all I was saying :skep:

My surgeon quoted us his statistics:

Out of 1000+ RNY, he's lost 4 patients.

Out of 100+ lap bands, he's lost none.

Long term complications: in the long term, he's seen roughly equivalent rates.

Surgery *should* scare the bejeezus out of you. If you're scared, it just means you're sane. But considering the complications and fatality rates of avoiding it, an obese patient is more likely to enjoy a longer, healthier life with surgery than without.

If diabetes is involved, I wouldn't consider the band: there's a significantly greater chance of reverting diabetes with the bypass surgeries. I don't have diabetes and would rather leave my anatomy otherwise intact and open to future revision should an appropriate technology arise. For those reasons, I chose the band.

The million dollar question however is what did exactly his patients die from? RNY patients on average are much larger than bandsters. Did they die because they were super morbidly obese and would likely die from "any" surgery or did they die because of RNY complications?

Hi Shelski, I am a sponsor for a lap band patient who wants to undergo surgery. I have recently read many articles (Pubmed...so they are legit) that say there is a roughly 50% long-term failure rate due to complications, which should not be taken lightly. The actual mortality rate is low(.2% death rate) but deaths do occur. I am urging my friend to do more research, as this is seen by many as a low-risk cure-all for obesity, but may in the long run be cery costly due to re-operations and repeated doctor visits for adjustments. Among the issues patients have are vomiting, inability to eat healthy foods, and blockages. Nearly 50% have the band removed by the 7 year mark. I would not take entering into this surgery lightly, as many have little to no reduction in weight as well. Best of luck to you! =)

I had heard the same. As someone who has RNY I have to admit before surgery I was scared so bad. I had even left a note for my family in case I died on the table or shortly after surgery. I had a BMI of 46 so it's not like I was super morbidly obese or anything :tongue2:

Anyway, I was going to to the lap band but did a switcharoo 2 weeks prior to my surgery at my surgeon's request. He told me about these complications of Lap Band and that he didn't think I'd lose all the weight I wanted to and last but not least he said to me, "2 years down the road the last thing I want is for you to tell me you want a revision to RNY when we could just do it now" He told me that was starting to happen a lot.

Long story short, I had lap RNY, I made a mountain out of a molehill. I was up and walking 2 hours after surgery and the pain was very manageable. I felt so silly afterwards with all the worrying I was doing because it really wasn't a big deal at all!

Leaks and stuff you are right is a possibility but my surgeon has over 500 surgeries and no leaks. You do the math lol

I feel the same way. That is why I am pursuing LB.

Number one is absolutely correct. My "guts" are totally rearranged but then again that's the beauty of the surgery and why I am a "big loser" I used to see that as a bad thing. Now I just see it as no big deal.

2 and 3 are a bit questionable. I know people do die from GBP surgery however I've yet to find anyone who has. My surgeon has done over 500 of these surgeries and his stats are one death. That was due to pulmonary embolism. Something that couldve happened with Lap Band or any other surgery. The larger you are the riskier this surgery is. That is true with ANY surgery. Just being on a table under general anethesia puts you at risk if you are obese, and the larger you are the riskier it is. (I had mine done lap) Personally if I found a surgeon with the death rate of the national average I'd run the other way!

The issue of complications is debatable. I look at both boards and it seems there are a heck of a lot of comlications with lap band. So that's sort of a wash.

Wow! You look great! Congrats! Have you had any complications at all?

Zero complications for me. My labs have all been completely perfect.

Doesn't mean nobody has complications, I just havent experienced any at all. However most are like me.

I also like the fact that there is dumping syndrome with RNY. It keeps me straight. If I didnt have that I'd probably be drinking Wendy's frosties and Starbucks drinks. The fear of dumping keeps me right.

Thanks Mariem. I am still waiting for insurance approval and am still trying to collect as much information as possible to make my decision.

That's the best way to do it. If you have any questions on RNY please feel free to ask. Here's a before and now if you want to see. I dont think I like "sickly" at all like some people think of RNY'ers post op :biggrin:

Before

6 months later

mariem "He explained that with gastric bypass the complications are generally within the first couple of months then the complications go way down. With the band it's the oposite, very few in the beginning and then from one year and beyond there are many."

What are the side affects after a year for lapband patients?

Port flips, your body's rejection to a foreign object, errosion of the band, band slippage just to name a few. Im not saying mine is better than yours. Im just saying that as a person who was so dead set on the band, I wasn't looking at RNY as a possible solution in fact it scared the hell out of me.

When I actually looked at the average person who had RNY there were very, very few with complications.

The other factor is that I was approved through BC/BS of Mass. That insurance goes away next month and I am back on the same crappy insurance I had before I started this process (husband went back to his old company) If I had the Lap Band I would be scared right now because there is a WLS exclusion on this policy. I dont know what wouldve happened if I had the Lap Band and these complications cropped up. They definitely wouldn't have paid for my fills that's for sure.

Other than my yearly labs I am done. No fills, nothing in my body to go haywire etc.

I support everyone in their weight loss journey, I just wanted you to know there are many, many people like me who have done a lot of research and came to RNY as the best solution for our situation.

We are all in this together :biggrin:

I was so dead set on the lap band, researched the heck out of it in fact. It wasnt till my surgeon told me, "Mariem, you do realize if you are my average patient you will only lose 50% of your unwanted weight and that will still put you in the obese catagory"

He said it was up to me which surgery I wanted but asked me to do research on gastric bypass and that he felt it was best for me.

He explained that with gastric bypass the complications are generally within the first couple of months then the complications go way down. With the band it's the oposite, very few in the beginning and then from one year and beyond there are many.

Also, 100 pounds in 3 months is too much unless the person is super morbidly obese (like over 400 or 500 pounds) for us average RNYers I am about average losing 99 pounds at the 6 1/2 months I have had it.

No, Im not saying mine is better than yours. I just wanted to give you a viewpoint from someone who used to be so dead set on the band that I wouldnt even look at RNY as a possible solution. In fact all the reasons for not having it were all listed on this thread :biggrin:

Good luck to all of us wherever our journey takes us

Long story short, 2 weeks before surgery I told him I wanted RNY gastric bypass and that was on 1-8-09 I am now down 99 pounds and feel great.

Wow that was an old post of mine!! So much has happened since then. I ended up getting Gastric Bypass from Dr Berger in Flagstaff on January 8 of this year and couldnt be happier. I am now down 87 pounds as of this morning!

BC/BS of Mass ended up being a breeze. Most importantly I picked the right surgery for me.

Good luck to everyone here!

I am confused about the process I am in right now. Here is what's going on maybe someone can tell me what to expect.

I went to the information meeting in June. I was waiting for my BC/BS of Mass (Blue Care Select PPO) to take affect. It finally did August 1 so I called the office and gave them all the card details for my plan. The surgeon's office manager called back to tell me that I did not have a bariatric exlusion and that all my details were already on file with them. They said if my BMI was over 40 (which it is) then I am a candidate for this surgery. There were other things mentioned too such as failed attempts at weight loss and a willingness to lose a lot of weight. She said the failed attempts could be something as simple as writing down all my attempts over the years.

She then said she would send this on to their insurance specialist to get 100% information on what is required since I am 100% sure I want to do this. She said based on this call I will get an appointment set up with the surgeon.

Is the call they are making "the" call if they get the right answers? When the woman called me back after initially calling she said "Your insurance seems very easy compared to most" Though I am afraid to let me guard down and get too excited.

When they told me to write a diet history I thought the same thing you did, "How am I going to prove this"? But the dietician just said to do the best you can from memory and that was fine. I didn't have to show proof....how could you possibly do that? So don't worry, I'm sure they'll tell you the same if you question it.

I did write my diet history already. It's harder than it appears at first. Define attempts? Oh I have about 330 of those in any given year. It starts in the morning and ends at about 5pm feeling totally defeated.

On the other side I do have serious attempts like when I lost around 55 pounds on weight watchers. It just never works for me long term.

I honestly don't know anyone who is overweight who hasn't tried to lose weight at some point.

The reason I was worried about the diet plan and also the previous 5 years of spotty medical care where I wasn't weighed every year for the past 5 years without a 12 month gap is because that's what the doctor's office told me about some plans.

They said a lot of insurances make it nearly impossible to qualify and if you do they dont make it a fast process. She said a lot of insurances will ask for the person to follow a 6 month medically supervised diet. (as if we have never tried to diet before grrrrr)

When I read BC/BS MA policy on getting the lap band it seemed quite easy. Just qualify with the BMI and be willing to be enrolled in a program for after care and that's about it. Even the doctor's office when she saw that told me it looked easy but she had never worked with that insurance company before. She said, hopefully it's as easy as it appears.

Before the surgeon would submit my papers to insurance I had to attend 2 info sessions, see the nutrionist, see the pysch doctor, head of the department, bloodwork, gallbladder ultrasound, and then meet with the surgeon. The usually put all the appointments together. Mine was spread over 2 days and the 3rd time it was with the surgeon and then scheduled my surgery and preop appointment. Every hospital is different.

Liquidbluegal,

I have BC/BS MA too. I have done the first step of attending the seminar. I talked to the gals in the office and gave them my insurance info. They said they wanted to verify the insurance and get back with me with all that is required for surgery.

Did you need proof of 5 years of obesity? What about a 6 month diet?

I did see on the insurance info that they want a record of failed attempts of dieting. Did they just take your word for it or did you have to prove it?

I don't have that at all. What I do have is a BMI of about 43 with no co-morbidities.

Of course I did try to lose weight in the past 5 years, I just don't have proof of it. I also have lapses of time of having my weight recorded. I dont have 5 years of proof of my weight by being weighed every year at a doctor's office. I am just going off what they said some insurances are like.

Thanks!

Hi again, I said I would report back so here I am. I ended up canceling my appointment with the doctor I had and found another who I had went to in the past who I hadn't seen for 3 years in Sun City West. I had only seen him 3 times or so prior to that so it's not like I know him really well. He was very receptive to talking about my weight and is very supportive of me having WLS and will help me in the process. What I'm not getting is a doctor who knows a lot about the band. I don't think he is very knowledgeable but to be honest what I need at this point is a supportive doctor who is in agreement with my goal of being banded. From what you said, Snowbird, I don't think that helps you. you wanted a doctor who knew about the lapband and the side effects etc.

I'll still give you his name if you'd like though :thumbup:

snowbird,

Do you mean no pre approval at all? Just let them know I'll be going to Mexico for surgery and submit it myself for some sort of reimbursement? No 6 month diet or 5 years of weight history? If that's what you are talking about I would jump on it! At a 10% reimbursement of around 8K or so I'd happily pay the $800. I'll have to see if I have that sort of coverage.

Yes, as I said the worry of when the next attack and the pain will be worse than the surgery itself.

Just out of curiousity since I have yet to be banded, can you compare the two surgeries as far as down time and pain afterwards? Both are done laproscopically so I was thinking the pain after surgery I will have with the lap band would be nearly the same if not identical to the surgery I had to remove my gall bladder.

Glad you are on the mend and doing well!!

I have thought about Mexico as a possiblity but I would like to get my insurance to pay for it if all possible.

I am totally kicking myself right now. Next month I will be on BC/BS of Mass. PPO with a $15 co-pay and no co-pay for surgery or hospitalization. Also, no exclusion for WLS.

I am like a lot of people who have always struggled with weight. I had no co morbidities so I rarely went to the doctor. I despised going to the doctor because I was too embarrassed to get weighed. That was the real reason. I do have a few trips to the doctor for pap smears (not as much as I should) and for the rare occasion I was actually ill. I dont however have 5 years of being weighed in at least once per year. The last time I went to the doctor was Jan 07 so right there it's been 17 months. I can drag up what records I do have but I don't have what they are looking for. If I knew I was wanting to have lap band surgery 5 years ago I would've made sure to go to the doctor more frequently.

What I can prove is that for the times I have been to the doctor I have been at least over a 40 BMI. 5 years ago I went on WW so I got down to 35 BMI but that only lasted a year. I can also prove that since I have been in my 20's (I am in my 40's now) I have struggled with my weight and have always been around 40 BMI.

The guy I talked to at the doctors office has told me they usually make no exceptions. I am really depressed right now. What is everyone's take on this?

Kristiebandy

So when did you start this process? When was your orientation? Do you feel you are having this done much more quickly than if you had gone somewhere else?

I finally just told my husband a couple days ago that I am going to have this done in the near future. This is after researching the lap band for nearly a year and now finally getting insurance next month that doesn't have a lap band exclusion. He is not very supportive. He said that as long as it doesn't cost much out of pocket he doesn't care.

My mother in law has known for quite some time that I have been looking into it and is totally supportive. She would be, she's the only family member in my life who is obese and understands the struggles. She told me, "Do it and don't look back, if I were your age I'd do it" She is 74 now so it's not a choice. She is an RN and I want her to be there for me before and after surgery. Not my husband. (is that weird or what)

I have yet to tell my "skinny" family. How I got my fat genes is beyond me. I've always known I had the misfortune to have problems with food. My mom just really controlled my eating from an early childhood. It wasn't till I was out of her control that I really picked up the weight. I was always a normal weight under her control, but it wasn't easy. I am the only one who really struggles with weight. I just don't want to hear about it from them. I know my parents will tell me that if I just diet and exercise then I'll meet my goal (as if that has worked the past 24 years!) I don't think I'm going to tell them. I feel badly for not even telling my parents that I will be going under the knife but I don't see what I can gain by telling them. We are very close and talk nearly everyday. This is just something they don't understand and I don't think they ever will.

I was originally going to go to Bridges orientation but they scared me off by telling me I needed to be on a 6 month medically supervised diet.

When I called WLIA they told me that according to BC/BS of Mass. that there was nothing stating about a 6 month medically supervised diet, (though it would be in my best interest to get to a primary care doctor and get started on a relationship with her and talk about the lap band and my goals etc) I just have to have documentation of my weight over the past 5 years. I also asked Bridges when I called when would they actually look into what was needed to be approved and they informed me they would process everything when I was done with the 6 month diet. Maybe I just need to call them again and see if I get a different answer?

I went to the orientation yesterday at WLIA. I have to say I was impressed with Dr DeBarros and I liked that they made it seem as if it was so much easier to go with them because they will work to make sure my claim will be approved and will go the extra mile.

What I didnt like is the fact that the insurance I will be on will most likely cover 100% of the surgery with no co-pays yet I will still have to pay a co-pay and a deductible. This is because one of the doctors (and both will be there during the surgery) is not on the BC/BS plan. This most likely means my totally covered 100% procedure will cost me around $2500 - $3000 when you also take into account the program and other fees.

I have a few things that I am a bit worried about. First of all I dont have a primary care physician and my records are very sketchy over the past 5 years. A couple trips to urgent care for strep throat, a visit here and there for other things but nothing with exclusively one doctor. Other than that I'm pretty much a "healthy" person with a BMI of around 42. No, I dont consider having a 42 BMI to be healthy but I dont have any other problems. My weight has fluctuated a lot over the past 5 years but I've always been around the 40 BMI range.

I am now really regretting not seeing one doctor and having that person have all of my records. (Does urgent care even keep records easily at hand for the person who came there only once three years ago?)

Ok yes, I know this is getting long so I'll cut to the chase. I went to WLIA and they are asking for $2000 in program fees and other incidentals. Is this normal? It's sort of worth it to me if they can get me approved because of my sketchy past where others wont do much to get me approved.

Simply put are these programs fees the norm and how much do the other places do to get you approved for surgery?