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I had a consult with a surgeon and he's trying to talk me into the band. Given my bmi is only 36, He thinks I will loose a great amount of weight and become malnourished. I believe there are other reason for his push on the band. Like follow ups and the fills, means more $$. I over heard him through the wall, to the room next to mine, trying to push the band on another patient. Should I give the band a try first then have revision later if it fails?? So stressed over this!

Do a search for GERD here. We have plenty of folks that have been sleeved with it, too. Acid is an issue for many post op, but for the vast majority it fades before the first year post op. In my case, 4-6 months and I was off my PPI. I've been on it since for my pregnancy and two other short periods when I was under an incredible amount of stress. Other than that, the issue resolved and it's this way for many. Losing too much weight and being malnourished is hardly a concern here. You'll see the occasional voice chime in that they got smaller than they wanted, but it's rare. And you're only malnourished if you choose not to eat adequate nutrition and take your B12, multi and Iron, if needed. I did have an issue with B12 and iron, but I've always had iron/anemia deficiencies. Now I'm on supplements that help me feel better than ever before. Additionally, you'll see many people get revised to sleeve from the band - and many of those people do it in part due to stomach damage and acid problems! My opinion is that your doctor is just more comfortable with the band procedure. This happens and it's true that the sleeve still isn't done at the rate of the older band and bypass. Only you can make this decision, but I can tell you that I was dead set on a band and thought a sleeve was too drastic...until I did six months of research and lurked on the band talk site and saw how miserable people were with the band surgery. Best of luck and I hope that you find a solution that makes you comfortable. I chose to self pay because my insurance covers only band and bypass. ~Cheri

better to travel once for a sleeve than two or three times to get it revised.

I had a band to sleeve revision. Do not get the band. Unless you really want to have another surgery soon. I have spoken to hundreds of bandsters who are not happy. I was at goal when I had my revision, but needed my band out. I haven't become malnourished. Actually I am doing sooooo much better since I can eat proper foods without throwing up. Keep looking for another surgeon.

Quote I had a consult with a surgeon and he's trying to talk me into the band. Given my bmi is only 36, He thinks I will loose a great amount of weight and become malnourished. I believe there are other reason for his push on the band. Like follow ups and the fills, means more . I over heard him through the wall, to the room next to mine, trying to push the band on another patient. Should I give the band a try first then have revision later if it fails?? So stressed over this! I have had the band for five years and for about the first 2 1/2 it worked great. I am finishing my final process to have a revision to the sleeve. Because my complications with the band are becoming so unbearable! I am actually on an all starch diet due to gastritis which I have NEVER had in my life. Now with these last few weeks constant diarrhea and dry heaves are horrible and make u feel dizzy! Honestly I would choose the sleeve first if I knew what I know now. Aftercare is set up for any and everything required. You don't even come in till you feel you need it. Why put yourself through two surgeries the sleeve was the newest option When I got my band five years ago Chat With me privately if you want to keep talking about it

What Would Be The One Thing You'd Tell Future Bypass Patients To Help Them Through The First Few Months After Surgery?

Is there a military hospital that you can go to and get the sleeve if that is the surgery you really want. I refused RNY/bypass when I had to revise from the band and I listed the reasons below. I've also included the basic information about both surgeries. There are many reasons why I chose VSG instead of RNY, and my VSG was covered at a military hospital 100%. I would recommend checking out the obesityhelp.com website, look under surgical forums, check out the Revision forum so you can see how many people are looking to revise from RNY because of weight regain or complications, and then check out the failed weight loss surgery forum just so you can get an idea of people that are further out. Here are my reasons for getting VSG instead of RNY: The Vertical Sleeve Gastrectomy procedure (also called Sleeve Gastrectomy, Vertical Gastrectomy, Greater Curvature Gastrectomy, Parietal Gastrectomy, Gastric Reduction, Logitudinal Gastrectomy and even Vertical Gastroplasty) is performed by approximately 20 surgeons worldwide. This forum is titled “VSG forum” to include the two most common terms for the procedure (vertical and sleeve). The earliest forms of this procedure were conceived of by Dr. Jamieson in Australia (Long Vertical Gastroplasty, Obesity Surgery 1993)- and by Dr. Johnston in England in 1996 (Magenstrasse and Mill operation- Obesity Surgery 2003). Dr Gagner in New York, refined the operation to include gastrectomy(removal of stomach) and offered it to high risk patients in 2001. Several surgeons worldwide have adopted the procedure and have offered it to low BMI and low risk patients as an alternative to laparoscopic banding of the stomach. It generates weight loss by restricting the amount of food (and therefore calories) that can be eaten by removing 85% or more of the stomach without bypassing the intestines or causing any gastrointestinal malabsorption. It is a purely restrictive operation. It is currently indicated as an alternative to the Lap-Band® procedure for low weight individuals and as a safe option for higher weight individuals. Anatomy This procedure generates weight loss solely through gastric restriction (reduced stomach volume). The stomach is restricted by stapling and dividing it vertically and removing more than 85% of it. This part of the procedure is not reversible. The stomach that remains is shaped like a very slim banana and measures from 1-5 ounces (30-150cc), depending on the surgeon performing the procedure. The nerves to the stomach and the outlet valve (pylorus) remain intact with the idea of preserving the functions of the stomach while drastically reducing the volume. By comparison, in a Roux-en-Y gastric bypass, the stomach is divided, not removed, and the pylorus is excluded. The Roux-en-Y gastric bypass stomach can be reconnected (reversed) if necessary. Note that there is no intestinal bypass with this procedure, only stomach reduction. The lack of an intestinal bypass avoids potentially costly, long term complications such as marginal ulcers, vitamin deficiencies and intestinal obstructions. Comparison to prior Gastroplasties (stomach stapling of the 70-80s) The Vertical Gastrectomy is a significant improvement over prior gastroplasty procedures for a number of reasons: 1) Rather than creating a pouch with silastic rings or polypropylene mesh, the VG actually resects or removes the majority of the stomach. The portion of the stomach which is removed is responsible for secreting Ghrelin, which is a hormone that is responsible for appetite and hunger. By removing this portion of the stomach rather than leaving it in-place, the level of Ghrelin is reduced to near zero, actually causing loss of or a reduction in appetite (Obesity Surgery, 15, 1024-1029, 2005). Currently, it is not known if Ghrelin levels increase again after one to two years. Patients do report that some hunger and cravings do slowly return. An excellent study by Dr. Himpens in Belgium(Obesity Surgery 2006) demonstrated that the cravings in a VSG patient 3 years after surgery are much less than in LapBand patients and this probably accounts for the superior weight loss. 2) The removed section of the stomach is actually the portion that “stretches” the most. The long vertical tube shaped stomach that remains is the portion least likely to expand over time and it creates significant resistance to volumes of food. Remember, resistance is greatest the smaller the diameter and the longer the channel. Not only is appetite reduced, but very small amounts of food generate early and lasting satiety(fullness). 3) Finally, by not having silastic rings or mesh wrapped around the stomach, the problems which are associated with these items are eliminated (infection, obstruction, erosion, and the need for synthetic materials). An additional discussion based on choice of procedures is below. Alternative to a Roux-en-Y Gastric Bypass The Vertical Gastrectomy is a reasonable alternative to a Roux en Y Gastric Bypass for a number of reasons Because there is no intestinal bypass, the risk of malabsorptive complications such as vitamin deficiency and Protein deficiency is minimal. There is no risk of marginal ulcer which occurs in over 2% of Roux en Y Gastric Bypass patients. The pylorus is preserved so dumping syndrome does not occur or is minimal. There is no intestinal obstruction since there is no intestinal bypass. It is relatively easy to modify to an alternative procedure should weight loss be inadequate or weight regain occur. The limited two year and 6 year weight loss data available to date is superior to current Banding and comparable to Gastric Bypass weight loss data(see Lee, Jossart, Cirangle Surgical Endoscopy 2007). First stage of a Duodenal Switch In 2001, Dr. Gagner performed the VSG laparoscopically in a group of very high BMI patients to try to reduce the overall risk of weight loss surgery. This was considered the ‘first stage’ of the Duodenal Switch procedure. Once a patient’s BMI goes above 60kg/m2, it is increasingly difficult to safely perform a Roux-en-Y gastric bypass or a Duodenal Switch using the laparoscopic approach. Morbidly obese patients who undergo the laparoscopic approach do better overall in their recovery, while minimizing pain and wound complications, when compared to patients who undergo large, open incisions for surgery (Annals of Surgery, 234 (3): pp 279-291, 2001). In addition, the Roux-en-Y gastric bypass tends to yield inadequate weight loss for patients with a BMI greater than 55kg/m2 (Annals of Surgery, 231(4): pp 524-528. The Duodenal Switch is very effective for high BMI patients but unfortunately it can also be quite risky and may be safer if done open in these patients. The solution was to ‘stage’ the procedure for the high BMI patients. The VSG is a reasonable solution to this problem. It can usually be done laparoscopically even in patients weighing over 500 pounds. The stomach restriction that occurs allows these patients to lose more than 100 pounds. This dramatic weight loss allows significant improvement in health and resolution of associated medical problems such as diabetes and sleep apnea, and therefore effectively “downstages” a patient to a lower risk group. Once the patients BMI is lower (35-40) they can return to the operating room for the “second stage” of the procedure, which can either be the Duodenal Switch, Roux–en-Y gastric bypass or even a Lap-Band®. Current, but limited, data for this ‘two stage’ approach indicate adequate weight loss and fewer complications. Vertical Gastrectomy as an only stage procedure for Low BMI patients(alternative to Lap-Band®and Gastric Bypass) The Vertical Gastrectomy has proven to be quite safe and quite effective for individuals with a BMI in lower ranges. The following points are based on review of existing reports: Dr. Johnston in England, 10% of his patients did fail to achieve a BMI below 35 at 5 years and these tended to be the heavier individuals. The same ones we would expect to go through a second stage as noted above. The lower BMI patients had good weight loss (Obesity Surgery 2003). In San Francisco, Dr Lee, Jossart and Cirangle initiated this procedure for high risk and high BMI patients in 2002. The results have been very impressive. In more than 700 patients, there were no deaths, no conversions to open and a leak rate of less than 1%. The two year weight loss results are similar to the Roux en Y Gastric Bypass and the Duodenal Switch (81-86% Excess Weight Loss). Results comparing the first 216 patients are published in Surgical Endoscopy.. Earlier results were also presented at the American College of Surgeons National Meeting at a Plenary Session in October 2004 and can be found here: www.facs.org/education/gs2004/gs33lee.pdf. Dr Himpens and colleagues in Brussels have published 3 year results comparing 40 Lap-Band® patients to 40 Laparoscopic VSG patients. The VSG patients had a superior excess weight loss of 57% compared to 41% for the Lap-Band® group (Obesity Surgery, 16, 1450-1456, 2006). Low BMI individuals who should consider this procedure include: Those who are concerned about the potential long term side effects of an intestinal bypass such as intestinal obstruction, ulcers, anemia, osteoporosis, protein deficiency and vitamin deficiency. Those who are considering a Lap-Band® but are concerned about a foreign body or worried about frequent adjustments or finding a band adjustment physician. Those who have other medical problems that prevent them from having weight loss surgery such as anemia, Crohn’s disease, extensive prior surgery, severe asthma requiring frequent steroid use, and other complex medical conditions. People who need to take anti-inflammatory medications may also want to consider the Vertical Gastrectomy. Unlike the gastric bypass where these medications are associated with a very high incidence of ulcer, the VSG does not seem to have the same issues. Also, Lap-Band ® patients are at higher risks for complications from NSAID use. All surgical weight loss procedures have certain risks, complications and benefits. The ultimate result from weight loss surgery is dependent on the patients risk, how much education they receive from their surgeon, commitment to diet, establishing an exercise routine and the surgeons experience. As Dr. Jamieson summarized in 1993, “Given good motivation, a good operation technique and good education, patients can achieve weight loss comparable to that from more invasive procedures.” Next: Advantages and Disadvantages of Vertical Sleeve Gastrectomy >> This information has been provided courtesy of Laparoscopic Associates of San Francisco (LAPSF). Please visit the Laparoscopic Associates of San Francisco. Advantages and Disadvantages of Vertical Sleeve Gastrectomy Vertical Sleeve Gastrectomy Advantages Reduces stomach capacity but tends to allow the stomach to function normally so most food items can be consumed, albeit in small amounts. Eliminates the portion of the stomach that produces the hormones that stimulates hunger (Ghrelin). Dumping syndrome is avoided or minimized because the pylorus is preserved. Minimizes the chance of an ulcer occurring. By avoiding the intestinal bypass, almost eliminates the chance of intestinal obstruction (blockage), marginal ulcers, anemia, osteoporosis, protein deficiency and vitamin deficiency. Very effective as a first stage procedure for high BMI patients (BMI > 55 kg/m2). Limited results appear promising as a single stage procedure for low BMI patients (BMI 30-50 kg/m2). Appealing option for people who are concerned about the complications of intestinal bypass procedures or who have existing anemia, Crohn’s disease and numerous other conditions that make them too high risk for intestinal bypass procedures. Appealing option for people who are concerned about the foreign body aspect of Banding procedures. Can be done laparoscopically in patients weighing over 500 pounds, thereby providing all the advantages of minimally invasive surgery: fewer wound and lung problems, less pain, and faster recovery. Vertical Sleeve Gastrectomy Disadvantages Potential for inadequate weight loss or weight regain. While this is true for all procedures, it is theoretically more possible with procedures that do not have an intestinal bypass. Higher BMI patients will most likely need to have a second stage procedure later to help lose the rest of the weight. Remember, two stages may ultimately be safer and more effective than one operation for high BMI patients. This is an active point of discussion for bariatric surgeons. Soft calories such as ice cream, milk shakes, etc can be absorbed and may slow weight loss. This procedure does involve stomach stapling and therefore leaks and other complications related to stapling may occur. Because the stomach is removed, it is not reversible. It can be converted to almost any other weight loss procedure. Considered investigational by some surgeons and insurance companies. Next: >> Frequently Asked Questions About Vertical Sleeve Gastrectomy This information has been provided courtesy of Laparoscopic Associates of San Francisco (LAPSF). Please visit the Laparoscopic Associates of San Francisco. Bypass information

She did sum it up perfectly! I did contact my insurance company and the bypass and lapband are their two options. I just don't understand it. I've seen others have the same insurance as I do, and have the sleeve. Ugh. I just don't know what to do, but more research. Thanks for your input. Much appreciated to both you and Tiff. JJ

Thanks, Matt. I've always been leery of the full bypass. I can rememebr the "horror" stories of bypass patients from the 1980s when they first started them. Have they improved the procedure over the years? DO they still leave in the entire stomach, even though its cut away? I am not up to speed on bypass, at all. Then, to further add to the confusion, I've seen "mini" bypass, the "switch" thing and the "RY" thing and I don't know if they are all the same or different. I've got tons of reading to do to get up to speed.

I had gastric band in December 12 years ago, and a revision surgery one year later. I just had my bypass last week just in time for holidays. Will I miss turkey this year? Probably.but I will be with my family for the first time in a year. Also ironically I’ve always had a sweet tooth, but since my surgery, I can barely tolerate sweet tasting anything. Even if it is sugar free. You’ll do well. my way of expressing myself was to do a sketchbook for the Brooklyn art library sketchbook project. That’s been a great outlet for me. best of luck and positive thoughts to you! 🥰

Girls, Thank you for the morale booster!! And your all right... someone who's never had the xtra pounds can't and won't ever understand what we are going through. Whats scary is something I read about a year ago. We who are obiese have a 97% chance of failling at this losing weight game. Most will lose and gain it back within the next 5years... The odds are stacked againts us. And before learning about the lapband all I knew heard about was the gastric bypass and that wasnt an option. To answer Kathy's question, my wife was always pretty small but gained maybe 25 to 35 pounds these last 3-5 years. New position at work and thats making her a little less active. And thats pretty much the same problem I had. I was always a "big" guy but ever since I became an "in house" rep and no longer on the road I gained a shit load of pounds. I always thought I was at a 275-300lbs until the doc got me on the scale and that seriously freaked me out... I was so ashamed... of myself and of telling my wife. Put it this way, I'm now over the 365 point and its killing me. My mind is pretty much made up. But the one thing thats killing me about this, and this is the only thing that REALLY bothers is... is the no drinking while eating and nothing for the following 2 hours. You see, I NEED something to drink while I eat, or at least right after i'm done.

I agree that you should try dieting first even if only for a short time whether it be Weight Watchers, Jenny Craig or just watching what you eat. As RestlessMonkey said, the Lap Band is not forced dieting, it takes commitment from you and if you have never dieted before then you don't know if you can make that commitment. I think Gastric Bypass is more like "forced dieting with no turning back".

Of course there are pros and cons to both.....I crossed Bypass off the list because of the long-term complications I've read about in several studies published in medical journals from the Bypass and malnutrition, as well as searching for patients who had the surgery over 5 years ago on forums (I couldn't find many). There are complications that can arise with the band as well, but the band, you can take it out if you run into trouble. The bypass is for life-complications and all. Please, please look into the evidence (and lack of long-term info out there) that shows the problems so many GBP patients are having getting in the necessary Vitamins and minerals. Long term Vitamin A deficiency means you could lose night vision (no more driving at night!). Long term Calcium deficiency means you could have early onset osteoperosis and break bones easily. These things are happening to people who have been taking all of their prescribed supplements. There's just not a whole lot of positive evidence from cases 10+ years out from having GBP surgery. And yes, I am extremely obsessive in doing this kind of research! Did patients lose the weight, and quickly? Mostly yes, but at what price in the long term? It bothers me that people aren't talking about this more. We are supposed to be turning to WLS because we are done with the "quick fix" method to weight loss (meaning losing a lot and losing it fast), so if that's the attraction for anyone, they need to put that aside when making their decision. My BMI is 47-point-something, and I am actually looking forward to putting in the work in my eating choices and exercise this time because this time, I will also have this tool as an additional motivator and assistant in fighting hunger. It's going to take longer than if I had chosen bypass, but I'm okay with that. I think if you are going to be successful with the band, it doesn't matter how much weight you need to lose, what matters is that you are willing to change your life; commit to healthy eating and exercise, and the band will help you get to your goal. Of course, whatever you do decide is what must be best for you. Just weigh your decision very carefully and practically. And good luck to you!

I took my thyroid meds the day after surgery, that pill is tiny. I could also take my PPI capsule five days after surgery. Ask your doc, some things you may need to cut in half or sprinkle in applesauce, but others may be just fine to take as they are. Extended release meds are problematic for bypassers.

Right after surgery, your body is in a major heal mode for a couple weeks and it is difficult for some patients to meet their daily Fluid and Protein requirements. But keep trying each day and you should be able to get there. The three most important elements after gastric bypass surgery are to meet your daily protein, fluid and Vitamin requirements. food is secondary because your body is converting your stored fat into the energy that drives your body. Thus you lose weight. Weight loss is achieved after RNY gastric bypass surgery through meal volume control. You begin at 2 ounces (1/4 cup) per meal and gradually over the next year and a half increase the volume to 1 cup per meal. With this minuscule amount of food, it is next to impossible to meet your protein daily requirements by food alone, so therefore you need to rely on supplements such as Protein shakes.

You're welcome! 🤗 I got my band in 2013, and within a year or so I hit my lowest weight and I got stuck about ten pounds above that number. For years I was stuck. I gained about another ten back after GERD, and I thought that I wouldn't be able to lose anymore weight either. But it's coming off. And as far as not feeling restriction... I feel/felt the same way, but this week I started eating grilled chicken again for the first time since before the revision, and now I feel soooo much restriction. My surgeon told me that I have some nerve damage from the band and that's why I wasn't feeling restriction. But I can definitely feel it now as I'm able to eat denser proteins. Previously I was still eating a lot of chicken that I made in the crockpot, so it was a softer consistency. I think you will notice more restriction once you're fully healed. You're early out still. Give it some time and just follow your surgeons eating plan and track your protein and water. You got this! Best wishes!

I had sleeve to bypass revision on Aug 29. I have only lost 14 lbs. I had the revision due to severe reflux.. my dr told me he doubted I would lose anymore than I already have at my follow up Monday. It was really discouraging. I have about 80 lbs to lose and hearing I probably wouldn’t lose more with this surgery was a blow. I have been getting my fluids and proteins in with no issues. I don’t feel like I have restriction either. The scale hasn’t budged since I was 1 week post op. My concerns were shrugged off at my drs office and I didn’t know where else to turn. Can someone give me some insight or point me in another direction? I need this additional weight off too :( help.

14 lbs in two weeks is excellent. I lost 16 lbs the whole first month! (not a revision - I have a virgin bypass). people tend to lose slower after revisions than they do a virgin surgery - but again, 14 lbs is quite a lot. I wouldn't throw in the towel yet...

omg, you have lost heaps of weight.... you are 69 kilos from.........169 kilos. You are a new person. Congratulations for working so hard. A gastric bypass is a sleeve, isn't it? I'm getting very plump atm. Do you know if my metabolism change when the lap band is taken out? How long did it take for you to decide to get a gastric bypass? Have you had any problems? Ill be doing mine in September to get my tummy to heal for a good amount of time.....

@@mckwestla I think it is a personal decision and each of us has our own reasons for our selection. For me it was the fact that long term data about the sleeve is showing almost as good total weight loss as the bypass, using a simpler procedure with less risk and less side effects (malabsorption, dumping syndrome, etc.) I also consulted with my surgeon and based on my weight, health and reasons behind my weight gain he agreed that the sleeve was the best option. If you haven't already, a good conversation with your surgeon should help you decide. I would ask about the residual effects of both procedures. For example, the sleeve removes about 75-80% of the stomach, including the fundus which is where ghrelin (hunger hormone) is generated. Thus, sleevers have relatively little actual hunger. The bypass does resect the stomach but leaves the old stomach, including most of the fundus in place. I think it would be worthwhile to know whether the same ghrelin reduction occurs in the bypass. Also, I've heard that the sleeve has, over time, less risk of stretching than the bypass pouch. I don't know this to be the case, just have heard it and it is worth asking about. Hopefully the surgeon you select can help you choose the best procedure for your needs.

Which surgery are you having? Glad you passed the psych eval... I am one of them shrink types and felt like I had fooled them, too! About the doubt... normal for most of us. For me, after decades of failure, it is unreal to even contemplate that I could lose this weight. But, I did. Now that the rapid loss period is over for me, I am facing the reality of having to be very careful. But, the good news is that my pouch is small, I literally can't overeat. The bypass part of the surgery is there always, helping cut nutrient absorbing, and honestly, it is easier to avoid weight gain and with careful eating and good activity, the pounds are still coming off. I still am shocked when I look in the mirror or see myself in a window reflection... but I deserve this new body.

Thank you all for the get well wishes. I have had nausea since my sleeve June 10th and I'm dehydrated with low blood pressure. My surgeon said that with the sleeve you still have a biliary duct and he believes that is what's causing the nausea and dehydration. I'm so scared for the gastric by pass but he said when he makes the pouch the nausea will instantly go away. I don't have much of a life right now and he said If I hold off another couple of weeks and maybe the nausea will go away. But it's not a guarantee. From all of my research on the sleeve I had never heard of sleeve revision to gastric by pass. My husband was here with me all day at the hospital I couldn't help but cry when he left . I feel horrible, scared and sadden by all that is happening to me. I have to try to stay positive. I just find it hard to do so. So help me God.

Just take it one day at a time sweetie. It's gonna get better. You will be fine if they revise your sleeve to bypass. And you may be ok after some time with your sleeve. You just have to decide what's best for you. I know it's hard to make any kind of decision when your so sick. When hubby comes back make him curl up with you. That always makes me feel better. You will be in my thoughts and prayers!!!!

I haven't had to do shakes. I'm doing lean and green and then liquid diet starting the Sunday prior to surgery. I go for pre op on Thursday and hope to get more information then. Was originally going to do sleeve and then changed it last week to bypass. I'm not nervous at all, I'm just afraid I won't lose all the weight. I finally decided to start exercising and am mall walking during lunch and treadmill at home in the evening...it's a start...terrified of the shakes, haven't heard of a good one yet, also the chewable vitamins....Lori

I choose the sleeve for three reasons: 1. My surgeon okayed drinking alcohol (down the road) with the sleeve and recommend lifelong abstinence with bypass. 2. My surgeon said the same about NSAID'S. I have quite a bit of arthritis and even down 80 lbs, I still need my ibuprofen. 3. I like the idea of just cutting off some of my stomach as opposed to all the plumbing rerouting and the whole dead stomach thing. I'm not sure about the whole hunger thing. If I avoid simple carbs, I'm not hungry, but if I eat them, I still want more (I'm in month 4).