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considering band removal - stuck on whether to do sleeve



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Hi All - thanks for reading and sharing any thoughts...

I was banded in July 2013, and had a great first year. I've lost just over 100lbs. Starting around July 2014 (when i'd steadily increased from 4CC to 7CC in band) i was feeling a lot of reflux and suspected i was too tight. i had 1CC removed but symptoms continued. I then went through close to 6 months of having no Fluid for a month, then trying a small fill, and ultimately going back and having the Fluid removed again. my symptoms often feel like my stomach is bloated and full of saliva - and sometimes, especially late at night when it's most uncomfortable, i end up vomitting and it's just bellyful of spit that comes out. i've had 2 upper GIs and 1 endoscopy and neither showed any issue with the band (slippage, etc). i had a 2nd opinion done last month and that doc concurred that the xrays show the band looks fine, but that i might just be in the small group of ppl who can't tolerate the band. he advised me to try a 1CC fill to see if i can tolerate any fluid at all - i tried that 2 weeks ago and have since had it removed. what's making me anxious now is that my stomach still hurts - still feels like fluid isn't always draining. sometimes i have a big cup of hot tea and then i feel it release down.

up until now i've been set against having the sleeve. i'm just anxious about something that permanent and the brief history of data we have on longer term effects (will i need that part of my stomach when i'm 80?)... and in part i think that finality of decision was b/c i imagined i would be able to keep my band in. i lost my 100lbs with the band in with fluid in it - the last 6 months with fluid in and out have been a total standstill. i am close enough to goal weight and feeling healthy in a way that i could be ok if i didn't lose anymore - but i'm just nervous that these last 6 months don't actually show me i can maintain and they're more of an anomaly. i'm glad i haven't gained - but can i really keep it off long-term without some surgical help...?

thinking much more about having the band removed and i'm just curious if anyone else has been in this same place - and if you were considering a revision to sleeve, what questions did you find helpful in ultimately making up your mind (in either direction)?

thanks so much!

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Keep on your doctor. If you are having issues as you describe with no Fluid in your band something is wrong. It could be as simple as your stomach is irritated and swollen where the band sits.

To answer your question insurance was the deciding factor for me. I was denied my request to revise to the sleeve. It probably would have been approved but I hadn't been going in for regular checkups. I can't see age being a factor in getting the sleeve. If it works today it will work when you're 80. However it is still just a tool. You have to eat the right foods and watch your caloric intake or it won't work either. Sounds like you're pretty disciplined with your band so you should have no problem with the sleeve. Good luck whichever way you decide to go.

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I am at the point where my doctor said he will not do anymore fills that I would need a revision. so I began to re read all the info on the different surgeries. I really liked what I read about the duodenal switch. your stomach is removed but the bottom part where the hunger hormone is. the rest of the surgery can be reversed. but the part I liked the most was that the complications were less and ppl didn't have problems with regaining their wt. check it out.

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Sorry you are experiencing some issues of unknown origin. I wonder what is causing the pain? Could scar tissue have built up already in the short time you've been banded?

I agree with you about the lack of longterm data on the sleeve. It seems to be the most popular surgery for bandsters going for a revision but it probably wouldn't be the one I'd opt for 'next'. I've had complications with my band that also started a year after being banded, and I haven't lost any weight in a year. I'm pondering what my next step will be since I can't get any more fills (anything above 5.0 provokes esophegal spasms and now I've developed a heart arrythmia as well) and I'm relegated to doing traditional dieting just to keep off the weight I lost during the first year.

I'll be curious to see what you end up deciding, so please keep us informed. I hope you will soon have your band-related issues resolved.

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Oh girl I didn't realize you were having so much trouble. I am so sorry to hear that. You have certainly kicked butt after surgery. We were banded the the same time. I'm wondering if they tried any medications to try and calm it down???? I don't have any input on the sleeve because I never researched it. For me having 3 autoimmune disorders my only option was the band and if it ever has to come out that will be it for me. I know it's scary about gaining it back and it happened to me but only because i had to take high doses of steroids again for months. You can keep it off if that ends up being your choice you have done so great and are such an inspiration to me!!! I wish you the best in whatever you decide but mostly I hope you get some relief of those symptoms soon!

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I was lap-banded in 2003. Start weight was 370, I got down to 270 in 2005, but it has been a yo-yo since. So much so, that my PCP recommended that I have the gastric sleeve procedure to improve my chances of reaching my goal of 160 lbs. Today, Feb. 4th, 2015, I took the first step - removal of the band in preparation for the second step - gastric sleeve procedure - scheduled for April 1st 2015. I grappled with this decision for a long time. But finally realized that my PCP was right, that I should have the gastric sleeve procedure if I was serious about losing the excess for good.

The removal of the band was done with very little discomfort by my excellent surgeon -Ragui Sadek of Advance Surgical Procedures. He will also perform my gastric sleeve procedure, on April 1, 2015. It is April Fools Day, but, the only fool would be me, if I decided to stop after the band removal.

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I was lap-banded in 2003. Start weight was 370, I got down to 270 in 2005, but it has been a yo-yo since. So much so, that my PCP recommended that I have the gastric sleeve procedure to improve my chances of reaching my goal of 160 lbs. Today, Feb. 4th, 2015, I took the first step - removal of the band in preparation for the second step - gastric sleeve procedure - scheduled for April 1st 2015. I grappled with this decision for a long time. But finally realized that my PCP was right, that I should have the gastric sleeve procedure if I was serious about losing the excess for good.

The removal of the band was done with very little discomfort by my excellent surgeon -Ragui Sadek of Advance Surgical Procedures. He will also perform my gastric sleeve procedure, on April 1, 2015. It is April Fools Day, but, the only fool would be me, if I decided to stop after the band removal.

so glad your band removal went smoothly! I've read many ppl who have the band removal and sleeve revision done in the same surgery - may I ask what influenced you having them done separately? Also - is insurance covering?

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Hi Avila1979, I have had the very same problems you have had the same X-rays etc. I got banded in 2010 have lost and went without the any Fluid due to issues and back and forth to the Dr., on the 2nd I went to see my Dr to get a fill 2cc had to go back Friday due to vomiting, hiccups and burping he took 1/2 out so far ok now. But I am so afraid of picking up the weight I had started to do so. Now I walk and exercise but still need the help.

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Hi All - thanks for reading and sharing any thoughts...

I was banded in July 2013, and had a great first year. I've lost just over 100lbs. Starting around July 2014 (when i'd steadily increased from 4CC to 7CC in band) i was feeling a lot of reflux and suspected i was too tight. i had 1CC removed but symptoms continued. I then went through close to 6 months of having no Fluid for a month, then trying a small fill, and ultimately going back and having the Fluid removed again. my symptoms often feel like my stomach is bloated and full of saliva - and sometimes, especially late at night when it's most uncomfortable, i end up vomitting and it's just bellyful of spit that comes out. i've had 2 upper GIs and 1 endoscopy and neither showed any issue with the band (slippage, etc). i had a 2nd opinion done last month and that doc concurred that the xrays show the band looks fine, but that i might just be in the small group of ppl who can't tolerate the band. he advised me to try a 1CC fill to see if i can tolerate any fluid at all - i tried that 2 weeks ago and have since had it removed. what's making me anxious now is that my stomach still hurts - still feels like fluid isn't always draining. sometimes i have a big cup of hot tea and then i feel it release down.

up until now i've been set against having the sleeve. i'm just anxious about something that permanent and the brief history of data we have on longer term effects (will i need that part of my stomach when i'm 80?)... and in part i think that finality of decision was b/c i imagined i would be able to keep my band in. i lost my 100lbs with the band in with fluid in it - the last 6 months with fluid in and out have been a total standstill. i am close enough to goal weight and feeling healthy in a way that i could be ok if i didn't lose anymore - but i'm just nervous that these last 6 months don't actually show me i can maintain and they're more of an anomaly. i'm glad i haven't gained - but can i really keep it off long-term without some surgical help...?

thinking much more about having the band removed and i'm just curious if anyone else has been in this same place - and if you were considering a revision to sleeve, what questions did you find helpful in ultimately making up your mind (in either direction)?

thanks so much!

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My band is intertwined with my small intestine, crazy right, I have been in pain & discomfort for about 6 months been to the er twice, had a colonoscopy, endoscopy, and the ct scan finally found my issue. Up until now 2007 to current the band has worked good for me. Should I have him just remove it or install a brand new band?

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@aviva1979: While I can't chime in on your question about revising to the sleeve, only because this wouldn't be my choice, I wanted to address your concern about keeping your weight off if you were to decide to remove the band and not proceed with another WLS.

In my opinion, your concern is legitimate. I had complications with my band, not the same as what you are experiencing but complications that have me unable to have significant fill in my band ever, and may lead to me deciding to remove my band entirely. (I developed afib, with heart rate and rhythm problems related to the vagus nerve/band's influence on it).

After a first year of terrific weight loss and wonderful satisfaction with my foods and band, my issues set in and I could no longer have my band at optimal fill level. I have to keep my band open so there is no vagus nerve irritation. What I now experience is the "dieter's mindset", i.e. I have returned to having to control my weight by sheer will-power. I eat a Weight-Watcher's type of diet, which means lots of "filling foods" and I practice all the tricks that dieters/maintainers use to stay full and keep cravings at bay. This is the mentality I was happy to leave behind when I chose and underwent WLS so you can imagine how depressing it is to return to this state.

It really shows how effective our bands are when optimally adjusted. Yes, we do "some" of the work, but for me I'd say my band did "all" of the work...at least the important work...at helping me help myself. It was very clear that the band was responsible for my feelings of satiety and dimming of appetite because now, with a band that is basically dormant, I have neither of those.

If you were to remove your band and not proceed with another WLS, my sense is that in order to maintain, you'd have to eat precisely as you are eating right now. And that is very very hard without a WL tool. You'd really want to concentrate on how very good your feel now, almost at your goal weight, and combine that mental game with a diet that does not go over what you are currently eating calorie-wise. It's this last part that is very tricky, because you will be hungry...hungrier than with your band.

I have not lost any weight in over a year. The day my complications started was the day I stopped losing weight. I'm nowhere near my goal weight (I have 50 more pounds to lose) and I'd like to think I can get to my goal, or nearer to my goal, by myself. (I doubt I can, but I'll keep trying). I maintain my loss by keeping my mind on how much better I feel at this weight vs my pre-surgery weight, and I stay on a diet. It's not at all as joyful as when I had an active band, but I venture to say that it is a touch easier than when I had no band at all. The band alone provides me with a teensy bit of restriction so I can stay away from breads, Pasta, and other non-compliant foods, but it is not optimally-adjusted (so I'm hungry all the time).

Lots of bandster have revised, however, so those answers would be more relevant for you to read than mine. :)

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@Krazek444: I'm sorry you are having this complication. How could your band, situated so far away from the intestines, interwine with your intestines? Yikes!

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