How To Make This Decision?

[DebH 1]

I am approaching my 2 year anniversary with the lap band and have only lost 30 lbs which occurred in the first 3-4 months. Needless to say I am yet again feeling like a complete weight loss failure despite eating next to nothing, exercising regularly, and following up closely with surgeon, nutritionist and endocrinologist. Now my surgeon tells me it is not me that failed, but the band, and he is suggesting that I convert to the sleeve. I am not yet convinced that this will be any better for me. I was never an overeater prior to the lap band and was guaranteed that the band would work which it didn't. Now I am being told that I will have success with the sleeve, but I just can't understand how it would be any different since I hardly eat anything at this point anyway. I do not know if I am physically and emotionally up for the issues that would occur if I went through with this surgery and failed yet again.

I would appreciate any feedback from others that may have had similar experiences and how you came to decide on the conversion.

[Aimstergal 42]

I am approaching my 2 year anniversary with the lap band and have only lost 30 lbs which occurred in the first 3-4 months. Needless to say I am yet again feeling like a complete weight loss failure despite eating next to nothing' date=' exercising regularly, and following up closely with surgeon, nutritionist and endocrinologist. Now my surgeon tells me it is not me that failed, but the band, and he is suggesting that I convert to the sleeve. I am not yet convinced that this will be any better for me. I was never an overeater prior to the lap band and was guaranteed that the band would work which it didn't. Now I am being told that I will have success with the sleeve, but I just can't understand how it would be any different since I hardly eat anything at this point anyway. I do not know if I am physically and emotionally up for the issues that would occur if I went through with this surgery and failed yet again.

I would appreciate any feedback from others that may have had similar experiences and how you came to decide on the conversion.[/quote']

Hi, Deb. I am getting sleeved on October 15 and while I didn't originally have the band, in the orientation class, where they talk about each procedure (band, sleeve, bypass) among the 15 people who were attending the class, over 50% of the people there had already gotten the band and pretty much said they had the same experience as you. From what I understand, the band can stretch a great deal, which is why, as you know, all they adjustments. I've spoken to a few people as well who had the band first and then got sleeved and they were a lot more successful. I'm not saying the band doesn't work, I've just heard more stories of not working than working.

Obviously it's a personal decision. And being up to it both emotionally and physically is is a big deal. I suggest you talk to someone besides your doctor...support group, therapist, etc. they had you meet with a psychologist before the band, yes? Can you contact them to talk it out with you??

My new life begins October 15, 2012!

[CowgirlJane 14,261]

I revised from band to sleeve and they are very different. I don't know what to tell you about success with the sleeve. I was not a binge eater but i definately ate too big of portions before. I also ate the wrong things because I had discomfort and misery with the band and it kinda drove me toward slider foods. The thing is, it does not take eating massive quantities for some of us to get and stay fat. I used to eat dinner on a dinner plate, but not crazy portions. Now I eat dinner on a tiny little plate and have the rule that the food can't touch. Big difference.

The only way you really know what you are consuming is to accurately journal in myfitnesspal or some other software. It will tell you things beyond calories that might be enlightening. One of the things I have definately learned is that it is a plain lie that "a calorie is a calorie". It does make a difference WHAT you are eating too - carbs, sugar, versus Protein, Fiber etc.

Since you aren't eating much food, I wonder if you would start losing weight with the band if you just started following the sleever rules? It is pretty simple - Protein first, at least 60g a day, then healthy veggies, then fruit or other complex carbs like grains. Drink 64 oz of Water a day. Do not eat or drink within 30 minutes of each other. Exercise.

The lousy thing about any WLS is you usually lose pretty well at first, but it gets harder, and certainly maintenance requires work work work! Even so, the band really wasn't as good of a tool as the sleeve is!

[DebH 1]

I revised from band to sleeve and they are very different. I don't know what to tell you about success with the sleeve. I was not a binge eater but i definately ate too big of portions before. I also ate the wrong things because I had discomfort and misery with the band and it kinda drove me toward slider foods. The thing is, it does not take eating massive quantities for some of us to get and stay fat. I used to eat dinner on a dinner plate, but not crazy portions. Now I eat dinner on a tiny little plate and have the rule that the food can't touch. Big difference.

The only way you really know what you are consuming is to accurately journal in myfitnesspal or some other software. It will tell you things beyond calories that might be enlightening. One of the things I have definately learned is that it is a plain lie that "a calorie is a calorie". It does make a difference WHAT you are eating too - carbs, sugar, versus Protein, Fiber etc.

Since you aren't eating much food, I wonder if you would start losing weight with the band if you just started following the sleever rules? It is pretty simple - Protein first, at least 60g a day, then healthy veggies, then fruit or other complex carbs like grains. Drink 64 oz of Water a day. Do not eat or drink within 30 minutes of each other. Exercise.

The lousy thing about any WLS is you usually lose pretty well at first, but it gets harder, and certainly maintenance requires work work work! Even so, the band really wasn't as good of a tool as the sleeve is!

I appreciate your response, but I have been following a very disciplined diet. I am eating 800-1000 calories a day with 60-90 gms of protein a day. People have told me that I should eat more calories, but my doctors and nutritionist do not feel that is the issue because I am getting most of those calories through protein. I journal everything I eat/drink and my exercise on a program on my IPad. However with the band I have trouble eating most all vegetables and fruits so I basically live off of Protein drinks, greek yogurt and chicken, fish or meat in very limited quantities. I eat very little carbs and when I do, I remain gluten free because I feel that I also have a sensitivity to that as well. I have no trouble drinking and drink anywhere from 64-86 ozs of fluids a day. As for exercise I do P90X, Insanity, elipticle machine, supreme body, yoga and bicycling. I get one of those in 4-5 times a week. I am definitely not a couch potato as I am able to get this exercise in while also working full time and having other outside of work commmitments.

I am not looking for magic and have no problem with willpower and accountability. That is why I am having such difficulty with the decision to convert because I don't want to go through another surgery only to not see results again. No matter how much I look to everything I have done correctly since my band surgery I can't help but feel like a failure.

[sunshyneqtie 73]

Is it possible with your workout schedule that you need more calories than you are consuming? After years of yo yoing some of our bodies are pros at starvation mode.

[sunshyneqtie 73]

Sorry. Didn't read that all the way through.

I dunno. I have not had the lap band, but I do worry that I will fail with the sleeve. Once I was sick and did not eat for 12 days and lost nothing. I worry my body will just adjust to whatever I give it. All I can do is hope and try.

All the best to you!

[CowgirlJane 14,261]

I am not an expert on this - but from what you describe I have a very hard time seeing how the sleeve would cause you to lose weight. ALL the sleeve procedure does is reduce your appetite and reduce your capacity for food. Then, combined with the structure of how you are supposed to eat, gives you a shot in the arm to get weight off - the rest is up to the person. For me, i was hungry alot presleeve so the reduction in appetite and quantity "helped" me make better decisions. I went from eating probably in the 2000-3000 calorie a day range to under 1000. As the weight came off, it became easier to be active too - so that also helped.

I personally would want the surgeon to explain how it would work if you are already under 1000 cal a day, eating mostly Protein and doing high intensity exercise. There is nothing about the sleeve that would cause that same regimen to work if it is not working now.

I appreciate your response, but I have been following a very disciplined diet. I am eating 800-1000 calories a day with 60-90 gms of Protein a day. People have told me that I should eat more calories, but my doctors and nutritionist do not feel that is the issue because I am getting most of those calories through protein. I journal everything I eat/drink and my exercise on a program on my IPad. However with the band I have trouble eating most all vegetables and fruits so I basically live off of protein drinks, greek yogurt and chicken, fish or meat in very limited quantities. I eat very little carbs and when I do, I remain gluten free because I feel that I also have a sensitivity to that as well. I have no trouble drinking and drink anywhere from 64-86 ozs of fluids a day. As for exercise I do P90X, Insanity, elipticle machine, supreme body, yoga and bicycling. I get one of those in 4-5 times a week. I am definitely not a couch potato as I am able to get this exercise in while also working full time and having other outside of work commmitments.

I am not looking for magic and have no problem with willpower and accountability. That is why I am having such difficulty with the decision to convert because I don't want to go through another surgery only to not see results again. No matter how much I look to everything I have done correctly since my band surgery I can't help but feel like a failure.

[DebH 1]

Jane,

That is exactly my dilemma and I thank you for your honest and candid response. My doctor recognizes how little I eat but repeatedly cites that the sleeve will reduce appetite and cravings, but that is not my problem. He also states that recent research shows that metabolism slows with the band and metabolism will rise a bit with the sleeve. However, I already have an autoimmune thyroid disease and minimal metabolism as it is, so I can't bank on the sleeve increasing my metabolism all that much.

I am having more and more discomfort with the band and feel that eventually I will have to have it removed either way, just not sure if I should go for the conversion. I feel very comfortable with my doctor, but I have to admit a part of me thinks he is just looking as the profit he will make from an addition procedure.

[Soli3l 30]

I am too 2 yrs post op Realize Band, and I watch my diet and my doctor has recommended the sleeve. He states it is my diabetes and insulin that has kept me from loosing weight, but states the sleeve will cure my diabetes. I look at it this way...its the 2nd attempt at Weight Loss Surgery and not as serious as the Gastric Bypass which will be the last resort. He also advised that back when I got the Band, it was advertised as working for everyone...but that was not the end result.

[CowgirlJane 14,261]

Okay, so the "reason" that the sleeve will work - beyond the Portion Control - is because of the insulin resistance issue going away. I had not heard this, but it makes some sense although I don't understand the reasons that a smaller stomach causes this.

I have had fasting blood sugar of just under 100 for many many years - borderline. My A1C was in the pre diabetes range. The first bloodwork post surgery at 3 months showed a tremendous drop - my fastiing blood sugar was more like 77. I thought it was due to my dietary changes only, but I NEVER saw that drop when i was doing weight watchers and lost quite a bit of weight.

Maybe there is something about the sleeve that helps with the insulin issue.

I guess I would still be skeptical, BUT, what I do know is that for many of us it only takes eating a little bit more then we should to keep the weight on. Maybe the shift in insulin response is enough to help?

So, although I am a sleeve advocate, I am not sure about the strategy of planning another revision if it doesn't work. Ask your surgeon, but I thought that each successive WLS increases risk of serious complications. If I didn't believe in the sleeve, I would go straight for the RNY or more like the DS (although THAT is a scary procedure!).

[Threetimesacharm 1,400]

I had my revision on September 10th. Besides all of the weight loss issues you have, I do believe that the band is NOT forever and sooner or later you will have to get it removed. So what would you do? I will bet that without the band you will have a significant increase in hunger and most likely food intake. I say go with the sleeve, remove your band(keep for a souvenir) and see what happens with the sleeve, all you have to lose is weight!

[DebH 1]

I appreciate the feedback that I have received. I am still not 100% decided but at this point I am proceeding with the pre-surgery doctor's visits in possible prepapration for the conversion surgery. I am convinced that I can't keep the band on with the increasing discomfort it is causing me and I am indeed sure that without it I would probably eat significantly more so in some ways I do not feel that I have a choice. Even if I don't lose anymore I, at least should not gain if I keep my same routine. I also think that with the sleeve I would be able to eat more healthy foods like salad and vegetables which have been a roadblock for me these past two years. LOL I never thought I would miss salad!

[Swift Kate 72]

Hi there, I am an Australian bandit looking at getting the sleeve. I was banded two years ago but have only lost 16 kgs (34 lbs). Eating only soft foods and have never really found the green zone. Saw surgeon recently and he agreed the band not working for me and we talked about the sleeve. Up until recently he has done the revision in two operations with a three months wait between removal of band and the sleeve. This seems to be common practice in Australia. My surgeon told me that he has compared results between this option and doing the band removal and sleeve in one procedure. Would really appreciate some feedback as to both of these options. Have my next appointment with surgeon mid December and would like to have some information. Thank you.

[DebH 1]

While I at the same stage as you are I am not sure of the answer. In reading many of the posts on this site it does seem that a lot of doctors will take out the band and do the sleeve procedure at the same time as long as there is not any erosion of the stomach at that time. I am scheduled with the gastro Dr next week to arrange for an endoscopy to determine the state of my stomach. I think that will determine if both procedures can be done at the same time.

[marguerite 1]

Hi SwiftKate, I might be able to add something to the discussion.

Four years ago I had the lap band inserted. After 2 years it slipped up towards the esophogus and big problems resulted. So all the Fluid was removed. (lots more to say about the whole experience but that's for another post).

So now I had the stupid band with minimal constriction. It took me another two years to work up the courage for more surgery (and a relatively unproductive one at that). I didn't go for revision for 2 reasons: 1) was going through the public system and they only do removal and implanting of lapbands, no sleeves. 2) I have a sneaky feeling that scar tissue from banding boosts the chance of complications far beyond what I am comfortable with.

A few weeks after the band was removed, I spoke to the surgeon about getting a sleeve. He showed me the pictures of my scarred stomach, and strongly advised me to put off any weight-loss surgery for at least a year, maybe longer. Too dangerous, not necessary, only rich people are getting the sleeve because they need to look good, etc. etc. now that I think about it, the conversation was a bit strange.

I went away not happy, but also kind of confused about why he was telling me these things. Basically he said if I was healthy in every other way then I would be crazy to have more weightloss surgery at this point.

Something tells me he was thinking of our dear Lila S in Attention Aussie Sleevers forum. He would have definitely been one of the surgeons consulting on her case.

And then he summed it up by saying if I put on weight over Christmas then by all means come back and talk about the sleeve. Which he thinks I will need. Eventually. Hmmm.