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Revising to a tighter sleeve is not recommended, honestly if I stick to the rules of Protein first, even at 19 months out, I have little to zero room for junk food. You'll do great ! ! !

I'll just say a few things, because I know other folks will chime in. 1. Yep, the preop diet is tough. No lies. But you can do it, because almost everyone here that had a surgery did it, too. Turn here for support if you need it. 2. Post op the diet is NOT hard. It wasn't for me, anyway. I got to the point where I was tired of drinking my meals, but I did it with zero hunger and zero cravings. You'll be sore, a little weak and a little tired. Trust me, a cup of warm Soup (with some Protein added!) is going to be all you can handle. Unlike the band, once you're healed you can eat and expect to be able to eat, with restriction, every day. 3. Don't let any news about the band healing faster make you believe it's a better idea. It's not. It may heal faster, but 25% of those people that get one will need a follow up surgery. I recommend you do a search on this board for revisions, because there are a number of people here that had a hell-on-earth experience with their band before revising (some of them at their own expense) to a sleeve. You're making the right choice to get the sleeve. My insurance didn't cover the sleeve. They cover bands and RNY. I did my research and I'm very glad I didn't buckle and get the band just because it was covered. I paid for my own sleeve, but I'm going to lose this weight without the complications and aggravation of a band. I'm just over a month out, but I can tell you the surgery was worth every single penny. Take care. Do your research until you feel more comfortable and prepared. ~Cheri

I live in Lethbridge, and need to start travelling to Red Deer. I am a revision patient (had my band in 2003 in Sydney Australia) and have decided (due to pain) to have it removed and have the sleeve done. I have my first appointment on 7 September with the new surgeon. It is Dr Farries office and he now has another 2 surgeons working with him - which is good timing for me I guess. I have no patients for waiting - I do other weird things like go mad cleaning and sorting my house (which is good to some I guess) and starting buying things that I didn't before I started this journey again. Like I always say this site is a lifesaver. I would love to keep in touch with all you Alberta ladies. Glenda

Just my observations/research/opinions... The band as a long term solution - sometimes. Beyond the 4 year mark, I know, and have seen, and have read about, and have been told about a LOT more people who have it removed than who still have it. I personally do not have faith in it as a long term properly functioning device. I think people who keep their bands for more than a few years, and are truly complication free (not to be confused with have unknown/undiagnosed complications), are the exception rather than the rule. If your plan requires a supervised diet, you probably can't get around it. Having a history of going to the doctor and being weighed for your visit doesn't count, they want it to be doctor's visits specifically for the purpose of supervised diet. I had my band under UHC and they did not require the supervised diet, nor did I have comorbidities, and I was approved in about 3 days. But that's all so specific to your particular plan, take it with a major grain of salt. I've recently submitted my paperwork for revision surgery and my current provider (no longer UHC) requires a 6 month diet for all bariatrics. We're trying to see if the fact that I've had a lapband for going on 5 1/2 years, and have technically been under the surgeon's care during that time, will count. They are also trying to see if there's a waiver for revisions, or if it's truly required for all bariatrics. The office staff are more optimistic about that than I am, but we'll see.

From a strictly weight loss perspective, there is a lot of overlap between the two, with the DS being better for those starting in the higher BMI ranges. The sleeve works well in the moderate BMI ranges (35-50) and also works well above that with somewhat more intensive dieting and greater discipline needed in the long term. The DS is stronger in regain resistance than any of the other mainstream procedures, so is particularly good for those with long term yo yo dieting patterns. From a diabetes perspective, the sleeve is similar to the bypass, with remission/resolution rates of around 85%, while the DS typically sees 98-99% rates. This should not be overly surprising as the DS started as a procedure specifically targeting diabetes, to which the VSG was added to make it a WLS procedure. Longer term, the sleeve is still relatively new with only some five year data available for any kind of significant patient populations. There are some indications of somewhat significant recurrance after five years, though it is not clear how well correlated that may be with whatever regain problems some may be having. The DS does seem to show more significant staying power in the face of regain, which in itself is less of a problem due to the long term malabsorption, compared to the VSG or RNY Note that this only applies to the "classic" DS and not the newer SIPS/SADI/"loop DS" which is a different procedure for which there is little long term data. There is a fair bit of experience that indicates that the longer one has been diabetic, the longer it takes to knock it out even with the DS. My wife had been under treatment for it for some twenty years when she had her DS and it took the better part of a year for her to be off of all meds for it. Others, even long termers, will walk out of the hospital free of meds with either the sleeve or the DS - YMMV. She is still off of all diabetes meds after twelve years. My feeling is that for a younger patient, particularly one whose obesity problem is only "moderate" in WLS terms can do very well with just the sleeve, particularly if they concentrate on learning long term weight control. If necessary in the future, a move to completing the DS (which is based upon the VSG so one is half way there already,) if the diabetes comes back again can be done. Last year at one of our support group meetings i was chatting with a gal who was some 25 years out on a RNY and by all measures has been successful in her weight maintenance until some of life's stresses hit a few years ago and brought on some regain (not the total regain we sometimes read about,) - enough to bring her diabetes out of remission, so she was lining up to get that revised to a DS to knock it out again (she would have done the DS originally had it been available then.) All of these procedures can give you something of a "do over" and let you start relatively fresh, but one has to take that opportunity to learn how to manage oneself in the long term and not go back to whatever got us here in the first place. Good luck on whatever path you choose.

The liquid diet is a pain. I was an emotional mess when I had to do liquids for two days before surgery. It is so worth it though for the sleeve! Just get your mind set and do it. I went to Mexico for my band, so I understand what you are going through. I also have three kids. You will do just fine. The doctors are great there. I would have returned for my revision from the band to sleeve but my insurance took off the exclusion for WLS. Your kids are going to have a healthier, happier mom as a result of the wonderful sleeve. I know it is overwhelming sometimes right before surgery. Just know you are making a great choice. The sleeve really has changed my life. I feel so great and I love that I can keep up with my kids. I know you will have the same experience. Best wishes and keep us posted! You are going to do great!!!

I don't think the sleeve is to drastic. I had a revision on the 10th and the best thing that I could have done. The band is not forever and I believe that many over the years have complications and need it removed and it is also high maintenance. The sleeve is for life and no maintenance. Don't get me wrong it is a lifechanging surgery so you need to be prepared but in the long run the weight loss will overcome any obstacles.

@@shannon cruz acid reflux bad- take the band out and do the sleeve. i love, love, love my sleeve don't wanna burst your bubble but i was told that already having heartburn/acid reflux - this problem will usually continue or get worse just being honest from what i've heard someone on the board started off with the lapband - revision to sleeve - finally gastric RN y finally her heartburn is gone maybe your situation is different, if doc thinks sleeve is the way to go, great i would double check about the heartburn situation - since yours is so bad whatever your choice on which WLS - will be right for you good luck kathy

I don't know about others, but I chose VSG because; 1. It's a permanent change and you can eventually eat normal foods 2. Higher and quicker weight loss 3. Felt the LBS had way more complications than the VSG, which could cause increased follow up surgeries. 4. Did lots of research on both and my surgeon who I know from a previous hernia surgery recommended it for me. I don't look much at the mortality rates, they are very low comparatively and are a risk in any surgery. Recommend you look at the Lap Band revision category on this site. You may get a little more insight on why people are choosing the VSG

Yes I just found out I have it. I havent had my script filled because I am having to get the doc to revise it. The pills are too HUGE! I found out because she said my stomach had inflammation when they removed it and pathology came back postive. It made me nervous because I know it can lead to ulcers and with what little tummy we have we don't need ulcers. The treatment is suppose to get rid of it though. Did you have symptoms? I have mild unexplained nausea for little over a year. My PCP never tested me for it so it went undiagnosed until surgery.

Alrighty, things got real today!!! I'm so excited to be on the sugery schedule! Things have gone very fast. I made the decision to go for this new life on January 1st. I was in the enteromedics study with the recharge device. This has recently been fda approved, its a great device and it worked well for me....until there was a glitch and the thing shut off. So technically, I am having a revision.

I'm only almost 4 weeks out from revision surgery but I would say that so far I'm losing weight faster that initially with the band. Total weight loss including pre-op I've lost a little over 30 pounds so far. I hope that the weight keeps coming off. The band was very difficult. So far I don't have the hunger like I did with the band.

Hello mariecar, I am going for a revision to gastric bypass on September 4. I am in Windsor, Ontario I wish you the best, send me a message if you like before surgery. I don't know when I am starting my diet phase am just waiting on the information from the surgeon and nutritionist. Donna

Just want to congratulate all Sleevers on your success and wish you all a Happy Holiday. I am having revision to sleeve on 28 December and I am ready. I will be in hospital alone until the.New Year. Respond back if you would like, if not Happy New Year????

Robin thanks for the reply. Good luck to you with getting civilian approval for the sleeve. I understand about appointments and kids; I have an 11, nearly 3, and 1.5 yr, old believe me nobody wants to see me at an appt with them in tow. That's another reason I want to go to the base, it's 30 minutes closer than the Dr. I'll be 40 too really soon and was hoping for the revision around my birthday. I don't plan on telling anybody about the surgery and was hoping to just let them all jump to their own conclusion about me having a mid-life crisis or something. I really hope things go well for you...I'll be looking for updates.

There's a new ruling as of today for surgery for the morbidly obese. It states that if it is nationally accepted and medically necessary, it will be covered by tricare. Here's the link to the Federal Register Document on the Department of Defense Final Ruling. I think this could mean the sleeve will be covered as of march, but read it and see. There's a contact person and phone number in the document, so that might help with insurance issues. Here's the Link. DOD Ruling DEPARTMENT OF DEFENSE Office of the Secretary 32 CFR Part 199 [DOD–2008–HA–0057] RIN 0720–AB24 TRICARE Program; Surgery for Morbid Obesity AGENCY: Office of the Secretary, DoD. ACTION: Final rule. SUMMARY: This final rule adds a definition of Bariatric Surgery, amends the definition of Morbid Obesity, and revises the language relating to the treatment of morbid obesity to allow benefit consideration for newer bariatric surgical procedures that are considered appropriate medical care. The final rule removes language that specifically limits the types of surgical procedures to treat co-morbid conditions associated with morbid obesity and retains the TRICARE Program exclusion of nonsurgical interventions related to morbid obesity, obesity and/or weight reduction. This final rule is necessary to allow coverage for other surgical procedures that reduce or resolve comorbid conditions associated with morbid obesity and the use of the Body Mass Index (BMI), which is the more accurate measure for excess weight to estimate relative risk of disease. As new technologies or procedures evolve from investigational into generally accepted norms for medical practice, the statutes and regulations governing the TRICARE Program allow the Department to offer beneficiaries these new benefits. These changes are required in order to allow the Department to provide these newer technologies and procedures for the treatment of morbid obesity as they evolve. DATES: Effective Date: This rule is effective March 16, 2011. ADDRESSES: TRICARE Management Activity, Medical Benefits and Reimbursement Branch, 16401 East Centretech Parkway, Aurora, CO 80011– 9066. FOR FURTHER INFORMATION CONTACT: Gail L. Jones, Medical Benefits and Reimbursement Branch, TRICARE Management Activity, telephone (303) 676–3401. VerDate Mar<15>2010 14:08 Feb 11, 2011 Jkt 223001 PO 00000 Frm 00030 Fmt 4700 Sfmt 4700 E:\FR\FM\14FER1.SGM 14FER1 WReier-Aviles on DSKGBLS3C1PROD with RULES Federal Register /Vol. 76, No. 30 /Monday, February 14, 2011 /Rules and Regulations 8295 SUPPLEMENTARY INFORMATION: I. Background On December 27, 1982, the Department of Defense (DoD) published a final rule in the Federal Register (47 FR 57491–57493) that restricted surgical intervention for morbid obesity to gastric bypass, gastric stapling, or gastroplasty method (excluding all other types) when the primary purpose of surgery is to treat a severe related medical illness or medical condition. The severe medical conditions or illness associated with morbid obesity included diabetes mellitus, hypertension, cholecystitis, narcolepsy, Pickwickian Syndrome (and other severe respiratory disease), hypothalamic disorders, and severe arthritis of the weight-bearing joints. The DoD also limited program payments to two categories of patients: (1) Those who weighed 100 pounds over their ideal weight with a specific severe medical condition; and (2) those who were 200 percent or more over their ideal weight with no medical complications required. Program payment was made available as well in cases in which a patient, who originally met the criteria, received an intestinal bypass, or other surgery for obesity and, because of complications, required a second surgery. Payment was allowed even though the patient’s condition may not have technically met the definition of morbid obesity because of the weight that was already lost following the initial surgery. All other surgeries including non-surgical treatment related to morbid obesity, obesity, and/or weight reduction were excluded. The DoD used the definition of morbid obesity, which was based on the Metropolitan Life Table and used then by other major health care plans, as well as reflected the 1982 general opinion regarding which cases justify surgical intervention. The DoD decided, at the time, that it was necessary to be very specific in benefit parameters due to fiscal responsibility and to ensure that Program beneficiaries were not being exposed to less than fully developed medical technology or procedures. At the time the current regulation was written in 1982, gastric bypass, gastric stapling, and gastroplasty methods were the recognized surgeries for morbid obesity. However, in recent years, other bariatric surgical procedures have evolved and some have a substantial body of literature to support their safety and efficacy. Unlike the original rule that listed the specific surgical procedures and the clinical conditions for which coverage may be extended; this final rule authorizes benefit consideration for those bariatric surgical procedures that have moved from the unproven status to the position of nationally accepted medical practice, as determined by the Program standard of reliable evidence. Also in 1982 during development of the current regulation for morbid obesity, overweight and obesity were typically measured with height-weight tables (such as the Metropolitan Life Table). The 1982 regulation restricted eligibility for bariatric surgery to individuals who exceed their ideal weight for height by 100 pounds with an associated severe medical condition, or 200 percent or more over their ideal body weight with no associated medical condition required. This final rule changes the Program definition of morbid obesity to reflect the current nationally accepted medical use of the BMI, rather than the typical assessed height-weight table (i.e., the Metropolitan Life Table), to determine an individual’s eligibility for bariatric surgical treatment. The BMI is the more accurate measure for excess weight to estimate relative risk of disease. Since there now are more than 30 major diseases associated with obesity, the final rule requires the Director, TMA, to issue specific criteria for co-morbid conditions exacerbated or caused by (morbid) obesity, as determined by the Program standard of reliable evidence. This final rule does not expand the TRICARE benefit for morbid obesity surgery. However, it does make the specific procedures that are covered, as well as the clinical conditions for which coverage may be extended, a matter of policy. In other words, new bariatric surgery procedures may be added to the TRICARE benefit structure as such procedures are proven safe and effective and are established as nationally accepted medical practice as determined by the Program standard of reliable evidence.

Yes. Had my revision 10 mths ago, after having my band for 3 1/2 yrs (slipped for a yr). What do u want to know?

Hi. I've been thinking about having the band for years. I just started seriously looking into it this year and went to a seminar and actually started my pre-op requirements. But as I read more and more on the boards I am seeing more problems with it. I hear every day of someone else going for a revision to bypass or sleeve from the band because of various problems. I had thought at first that well, I will try the band and if it develops problems or doesn't work I can revise. Then I started seeing posts from people having the band removed that had problems from that. Scar tissue and hernias etc. At least one I've heard of recently whose band is eroded into their stomach and they won't remove it because it is too dangerous. Sooo.... I thought it best that I should research all the options. I have pretty much ruled out the bypass because I have heard of people dying from it. I know, not many, but still. The sleeve seems like it's just what i want now. I'm still reading and learning though. I have a seminar this week at Johns Creek hospital Atlanta with Dr. Titus Duncan. If anyone uses him please tell me what you think. I also have a seminar scheduled with Dr. Hart. If there is anyone else in the Atlanta area with other dr. suggestions please let me know. I'm in the south metro area. Thanks!

I wish that I knew of the sleeve and my ins covered it at the time I was banded. My only option was band or RNY. I can't have malabsorptive surgery, so band it was. Read my blog or my post "my Lapband story, long but worth reading". So many of the people I've known over the last 5 years have had their band removed, revised, mostly to VSG, and have long lasting damage from their bands. I have a GI motility disorder now, requiring new medications and it is having a huge negative effect on my quality of life. Banding requires a lot of follow up care and even if you do everything "right" things can go wrong, leaving you with the prospect of additional surgeries. PM me for more info. Ask your doctor why VSG is better than band.

Had my VSG revision (from LapBand) scheduled for tomorrow (8/15/17) in Mexico. Got down to do the pre-op testing. All was going well, vitals were all good, I lost the prescribed weight, but then... Apparently either I missed the question or it wasn't recorded properly in the pre-screen that I have had Hepatitis B in the past. Mind you, my HepB was 30 years ago and was acute (meaning no ongoing symptoms). Also, I had LapBand 8 years ago and there were absolutely no liver issues then and I have numerous liver panels through the years with no ongoing liver function issues. However, out of an abundance of caution - they want to run a fresh liver function blood test and the results take 10 days to process. Assuming it's good, they will reschedule. This means my surgery is postponed a minimum of two weeks and possibly longer depending on their availability. The real kick in the teeth is I have to stay on the pre-op diet the whole time.

If u cant eat u need to go to your GP or the local A and E .. Even tho you had it done privately our NHS still has a duty of care for anyone with health problems whether they are a result of private surgery or not. If they refuse to help you i would insist that they do or make a complaint to your local health authority or health trust. The NHS is looking to fund all those revisions for those breast implants that have been in the news recently and your surgery wasnt even cosmetic. You still are under the NHS whatever your had done .. good luck Where are you located ?

Hello, everyone! I am in the starting phase of the process to revise from my band (2013) to the sleeve. Since getting the band, I've changed jobs so no one here knows that I've had WLS. I didn't have much success with the band and am now heavier than when I got the band so I don't exactly want to announce that I'm looking into WLS to fix what I couldn't make work from my previous WLS. But with the process to revise, I'm meeting with a nutritionist (every two weeks), getting blood work, getting an EGD, meeting with my PCP, and many other doctor's appointments. This month alone I have over 6 appointments. I always try to make them first thing in the morning or the last appointment of the afternoon as to miss as little work as possible but I can see my manager is wanting to ask if something is wrong (she genuinely cares, not just nosy.) but I'm just not comfortable disclosing anything quite yet. I will certainly have an honest conversation with my manager once surgery is definitely happening and is scheduled but until then, I'd rather keep this to only family. Did anyone else run into this? I feel like I need a generalized excuse to give her to explain the abundance of appointments. I know she'll never ask but I feel like I need to give her something. Ideas?

My name is Mckenna am 25years old and live in texas. I currently have the realize band and have been having so many complications and I am going on about 5 years with it now. Since my problems have Been getting worse I finally said enough is enough and I am doing a revision to have the sleeve done the same day my band is taken out. Because of my complications I don't have to go through the waiting period I met with my surgeon today and after my nutrition meeting tomorrow I am all set to go as soon as the team or docs review my case because I use a center of excellence. If anyone could inbox me or comment with your wisdom or experiences that would be great! Thank you!

There is a forum for band to sleeve revision. There will be many helpful posts there. I had a revision after having my band also for 5 years. I had a fantastically skilled surgeon but did not have any issues with scar tissue from what I know. You won't regret doing this you will love your sleeve! Best of Luck! Happy New Year!!

I definitely agree that the sleeve forums can be a little too "life is wonderful" and need to be taken with a grain of salt. But I do have to say that I am living proof that you can loose 100+ pounds with the band and then have complications and end up having to have revision surgery. (Hell, I believe in the band so much I had it twice!) I think it ALL needs to be taken with a grain of salt. In the end, I think it's important to remember that we are all struggling the same battle and people are always going to be defensive of what works for them. With whatever site you use, make sure and take the time to search the complications forum. I know I am studying that section VERY carefully before my upcoming band to sleeve revision! With that said, had my band not slipped, I was down 100 pounds and loving life! And my mother and sister are both very happily banded and down a combined 120lbs! The band can be wonderfully successful, as can the sleeve... we just have to remember that nothing comes guaranteed. Let's support each other, not tear each other down!