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MI doc says 25% do not loose wgt

I was just a Dr. Pleatman's website (he's in Michigan) and he states the following:

With a large number of people undergoing LapBand placement, there is also a significant number of patients (up to 25%) who have not been successful in losing weight with the Band. I have now begun performing laparoscopic Removal of the LapBand, with conversion to Roux-en-Y gastric bypass on these patients. For further information on this procedure, email me or contact the office.

First time I've seen that statistic.

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Susan:

I suppose safety is a matter of perspective. For an operation as complex as gastric bypass, 1 in 200 mortality is considered safe. Several large studies have showed lower mortality in morbidly obese patients who have undergone gastric bypass as compared to those who did not have bariatric surgery at all. Pick your poison.

As far as reversibility is concerned, the gastric bypass does not involve removal of any part of any organ. The stapled stomach can be put back together, and the roux-en-Y can be undone. Certainly it is more difficult than snipping off a lapband, but that does not mean it is not possible.

Mark Pleatman MD

OK, this is the beginning of the Apocalypse.

I actually agree with Dr Pleatman on something - that's NEVER happened.

:faint:

{ I know, I know - he's the experienced surgeon, I'm just some random LapBand patient.} But honestly when I read his posts, I have always thought he was just a typical "cut and saw" surgeon who is more concerned with numbers on a clipboard rather than with how patients actually live their daily lives.

I thought his comments on "Get over it and Move on" were simply caustic and condescending. Now I think I'm either losing my bark or getting used to his bite. This is earth-shattering.:rolleyes For example:

I dream about having Band patients lose 1 pound per week. The fact is that some don't.

I agree - MOST don't. Omigawd, if I had lost 1 pound a week since being banded, I'd be in the negatives in weight now. Even during the first 2 years of banding, that would still be 100# (pounds) gone. And if I had lost 100# of my original weight, I could be a fashion model by now. But seriously, even with getting back to realistic goals, Dr Pleatman is right on this point. And most of the MANY banded folks I know don't lose anywhere near 52# a year or #100 in 2 years.

The bottom line here is that you have to have an honest discussion with your surgeon, and look into the reasons you eat, decide which surgical TOOL will work best for you.

Been there, done that, got the medical records to prove it. I just read the initial assessments by my own surgeon and the others I consulted with before my LapBand. Guess what, they all expressed that I seemed destined for Weight Loss Surgery success (except for one ultra-conservative who thought my BMI might be a bit too low for a drastic surgery. G-o-d Bless Him, first time I've been thought of being too small to do ANYTHING. ) I walked in to EVERY single consult with a full approval for RnY that I got myself, so I did all I could to be brutally honest about my life, my diet and my goals and then asked for their advice. Sadly since this was in 2001 most felt that the LapBand wouldn't help patients lose 70#-80# - sounds crazy but that was the thinking back them. It KILLS me to say this: but those docs who thought RnY may have been a 'more guaranteed' choice for me, may have been right. Now this is just my case, but man hindsight is 20/20, isn't it?

You can't pick based on which is cooler, which is safer, or which one worked for your friend. You have to decide based on which will work for YOU.

I agree. I'm a TechnoGeek and the mechanical 'geekiness' of this procedure totally was attractive to me. In my Patient Assessments done by my surgeon, I even read that I asked more technical questions than other patients ever did. Well I should have more seriously considered that all devices can fail, but that's another story. I think LapBanders tend to be a different breed, and many surgeons I know have said their LapBand patients tend to be a bit more techno-oriented & some are a bit more educated, and I personally think LapBanders tend to have an individualistic streak. Now with that in mind - did that attract us to such an unusual form of WLS? Any thoughts on this? I wonder why are some LapBand patients seem so different?

The safest easiest operation isn't worth crap if it won't work for you.

Oh man, so true. I went with the "safer" easier procedure and 5 years later I'm still fat (and according to my BMI of 30, I'm techincally still obese:mad:. ) In fact, I've even had major complications and I *do* sometimes think "Oh I could have had the RnY for all this time, money and effort." And though the LapBand was safer, am I better off now, considering that I'm still overweight?

So it's true. I have formally agreed with Dr. Pleatman on every point in one of his posts. I am agreeing with the man who has said painfully strong things about the LapBand and other weight loss procedures. So what is next? Gee, maybe eventually he'd convert me later, because my own surgeon ain't hearing it. Anyone got a spare plane ticket to Michigan?:)

Happy Band (and Non-Banded) Journeys to all

I am pro-band and would never get any other type of WLS. With that being said, I have no idea who Dr. Pleatman is or his qualifications as a doctor, but I must say that my surgeon stated that the RNY is reversible. This thread sparked my interest b/c knowledge is power and I want to be informed. I am convinced that rny is indeed reversible based on my research. Here's a website that confirms this: http://www.obesityhelp.com/forums/RNY/about.html.

As I have read Dr. Pleatman say, don't take his word or mine for that matter, do your own research. I believe you will find this statement to be true.

Even to my VERY unexperienced eyes, this doesn't seem so far fetched based on this pic. Surely, with the miracles of modern medicine, they could put the organs back together.

My husband had 12" of his colon removed and the surgeon didn't need the missing piece to put his colon back together.

On another note, I don't think it serves anyone well to call names or attack someone just b/c you don't agree. This is a place for ALL beliefs and opinions and I think that it is in good taste to show personal respect even if you disagree with an opinion.

If I am wrong, please feel free to correct me. I am open and willing to listen. We can all learn from each other if we keep an open mind with a positive attitude.

post-205997-13813132961771_thumb.gif

I'm not the type to typically respond to negative posts (and I'm probably gonna get myself in trouble here...but I'm feeling feisty tonight). I feel very compelled to defend my profession here :lol:

Dody-

If you are questioning if Dr. Pleatman is really a doctor, then I am questioning if you are really a nurse. Come on now, any nurse that has been through any sort of reputable nursing program would know how to do a literature search, or at the very least an internet search and EASILY see the 100's of articles that come up on RNY reversal!!!!!!!!! I certainly hope you don't make such uneducated comments to your own patients before you investigate and find out the correct answers, since such a huge part of our job is patient EDUCATION......

Enough said.......By the way, could it be possible you are actually a certified 'nursing' assistant??????????:)

Dody,

Dr. Pleatman is a respected bariatric (band and RnY) surgeon and, if the ill-informed and unwarranted rude comments you've been making don't scare him away, he is a valuable resource here.

You might want to take your Nurse Nancy Kit, find the Glossary and learn the definition of "reversible," as it applies to surgeries. It does NOT mean that there will be no evidence that the original surgery ever happened.

Good grief.

He is probably desperate for patients as much time as he spends on here with his spiels.

Oh, please. One of my favourite Plastic Surgeons spends a LOT of time on online boards talking, advising and speaking with patients who are thousands of miles away and would never be his patients. Does he do it just to troll for business? Doubtful - the man is booked solid months in advance. Is he passionate about Cosmetic Surgery? Yes and he thinks the Internet is a great tool - so he does post when he has time. I don't think that Cosmetic surgeon does it due to lack of available patients so I wouldn't think that of ANY doctor who posts online - not even one I don't agree with.

Of course, if you don't like RNY he is the man to re-do it for you too. He knows what no other surgeon knows how to do. His office is in a small cave in the backhills of Michigan. I'm sure he can give you the directions.

What the heck are you talking about? You insulted an entire geographic area - Geez!?!

Perhaps you should use the lap band as the tool it is designed to be

Oh, gee. Never thought of that - neither have the other hundreds of LapBand patients registered here. Thanks for the reminder.

By all means feel free to contact Dr. Pleatman. It sounds to me like he needs the business,.

I was actually being facetious. It was a concession to saying that I've totally zinged the man for things that he's said that I thought were tactless and condescending to all LapBand patients. But when someone is right, they're right and I admit it.

and best of luck to you while you are straightening out your own personal problems.

Oh and thank you for your inquiry on my personal problems. Actually the only really big one I have is the extra weight I'm carrying. You seem to be so full of answers (or full of something else :) ) so maybe you can help with that one. And why don't you also give an answer to the millions of obese and overweight adults in America. We're all listening... go right ahead.

I am a retired nurse and was one for 38 years.

Gee, what a loss to the entire profession of nursing. Enjoy your retirement. Oh and just so you'll know - it may have been a while since you left nursing. (Certainly it was a while since you started.) There have been much progress within the medical field including bariatric surgery and even revision/reversal of RnY surgeries now. It does happen. It's not common, but it happens and has been documented. Read up!

And, just to catch you up on other advances in the medical profession since you were in it - barbers can no longer do surgery now and they longer use leeches much anymore. Oh, good news - the bubonic plague is virtually cured now. :lol:

Thanks again for taking the time to respond.

Happy Band Journeys to all

Ok first of all I am not a nurse who knows or works with DR Pleatman.....But working in a hospital on a surgical trauma unit I have first hand seen several reversals of Gastric weightloss surgery. Particularly the RNY! He is not crazy and he is not just blowing smoke up your butts.......it can be done. It is not an easy surgery and there are alot of chances for several complications as well as the complications that you can have for having it done in the first place. So please give him a much needed break. He does know his stuff. He has said on several occassions to check out all information on your own and not to take what he said as word.........SO INVESTIGATE ON YOUR OWN!!! My hats off to him for being an honest and caring physican. He is one that offers free fills and free conversions if necessary when you have him do your lap banding. Come on how many do that in the states????? Very very very few.

Alexandra! Why do you have to go to bed so early?

No kidding!! Sorry everyone, I'm just seeing this now. On it.

  • 2 weeks later...

I think it's important to define success. I know that some posters are happy at a BMI of 30 and others are upset about having a BMI of 30. For me, coming from a BMI of 46, maintaining a BMI of 30 would be a success. I would have significantly reduced my health risks from obesity; I'd be at a more normal size; etc. I think part of this may result from whether or not you were thin most of your life... and then got fat... or were chubby/fat all of your life. As somebody in the latter category, MO since I was 21, being "just" obese is nice. LOL And a BMI of 30 is just one point from 29... which is overweight, not obese.

I agree with Favretti and others that the Band, for many, should be a first step. Why go for more complex and invasive procedures if one doesn't need to?

I was considered a very slow loser... losing 50 pounds in my first year. I had numerous fills, but very few stuck. To be honest, I ate too fast, so I PBed a lot. In my second year, I finally went back to my original surgeon (Rumbaut) for a fill. It was the magic touch. The perfect fill. I dropped another 45 pounds in 6 months and then became pregnant. Did my diet change?? No, not really. Did my exercise change?? No, not a lot...although I was a bit more regular with it. For me, the key was the right fill... which came after 7 or 8 fills.

With my love of ice cream and sweets, yeah, maybe the DS or RNY was a better choice for me... but I don't regret the band at all. I was young when banded, and still wanted to have kids. I was able to unfill my band completely and have two healthy, normal pregnancies. That is priceless to me. (Yes, I know many RNY people have healthy pregnancies too... I just didn't want the risk.)

Some tools/tips which may help less sucessful bandsters??

1) Try the powerseed. www.powerseed.com It's a device designed to help you eat more slowly. Basically, it beeps or flashes a light every few minutes to tell you to take a bite. After so many minutes, it flashes a different signal to ask you to evaluate fullness. It's fab. I use it even though I'm unfilled and will continue to use it after being refilled.

2) Pedometer. Get honest with yourself about how active/unactive you are.

3) The 1/2 plate fruit/veggies rule. When eating easily band friendly food, like ice cream. I always made sure to add a lot of fruit, such as berries or bananas... at least half the dish. The fruit would fill me up (wheras the ice cream passed right through), so I wouldn't eat as much.

4) Weight Watchers. Join and see just how many points you're eating. Be honest with yourself. Personally, with my band was the only time I could actually do weight watchers and stick to it. It helped me through a period in my first year when the fills weren't holding very well and I was losing slowly.

Peace,

Karla

fabftgrl:clap2: :clap2: :clap2: :clap2: :clap2: :clap2: :clap2: :clap2:

I agree and you are doing a great job. I belong to TOPS Taking Off Pounds Sensibly, which keeps my weight pretty steady without a 2nd fill.

when I first looked into the band, I thought I had hit paydirt. have the band and lose weight with no effort at all. well, I realised that it doesnt work that way, though I know a few people who think it does and insist on eating the way they used to without fills and also drinking copious amounts of alchohol without "counting" it in their calorie intake. I know people who insist that calories dont matter, they do in my experience.

so I diet, its the last diet I will ever have to do so whats one more after a life time of them.

My friend said to me about another friend who has lost almost zilch after 2 years of the band and blames it entirely (so what caused the weight PRE band? she just wont have it that you cant eat cakes candys drink bottles of wine each night and lose weight nomatter what your fitted with or without,) "jeez if my husband spent all that cash on a power tool then flung it in the garage saying it didnt put the shelves up for him or built that wardrobe by itself, Id kill him stone dead" lol

there have been times when I havnt lost weight and had to face up to the fact that ive eaten too much, sometimes it seems like youve eaten a miniscule amount but then add up those dreaded calories and find youve eaten about 3000 in bitty food that does you no good at all.

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