Hello Everyone,

I attended my first seminar yesterday in Columbus, Ohio. The surgeon speaking was Dr. Patricia Choban and I must say that I am a little discouraged by some of the things that were talked about.

She stated that only 65% of people with type 2 diabetes (that's me ) are cured and that is 2-3 years out from being banded.

Also, she stated that for those of us who's BMI is over 50 (that's me again) may not be candidates for the lapband due to the laproscopic procedure itself.:cry????

I don't understand this as I have had 3 laproscopic surgeries done without any concerns about my size hampering the procedure.

Now I have been thinking about the gastric bypass and that scares the heck out of me!!!

Don't get me wrong, I don't want the surgery just for this reason but I would give anything not to have to take 4-5 insulin shots everday, test blood sugars 6-8 times and so on and so forth.

Can someone please shed some light on this for me? I am also going to go to another seminar at Ohio State University so I am definitely exploring my options.

This forum is so helpful and I value all of your opinions.

Thank You

Try to remember that during the seminar the doctor must speak in generalities. She also needs to make sure that you don't have unrealistic expectations. Everyone has a different experience with the band. If you choose the band your experience will be unique to you. I have heard of many BMI 50+ folks having their surgery laproscopically. I was at 50+ when I was accepted for lap surgery. As far as the diabetes goes there are too many variables to predict each individual case.

Making a choice to have this surgery has its risks and benefits, but the odds are overwhelmingly on your side that your life and health will be significantly improved. There are no guarantees except that if you don't have surgery nothing will change.

The bottom line is that having the band itself does not guarantee that you will lose weight. You still need to avoid crappy foods, exercise, and follow the other guidelines. The band will help dim your appetite, the rest is up to you. Successful banded people accept this fact and try their best to do their part.

Bruce

laprascopic surgery can be technically more challengeing for people with a higher bmi but it was originally proposed as an options specifically for the higher bm patients because of the reduced risks of complications and quicker healing ( i have a starting bmi of 60.9)

I am also a type 2 diabetic and my bgls have gone back down to the normal range, they dropped when i lost around teh first 50 pounds- now, to put that in context, i was not on medication before losing weight but was about to be commenced on oral meds. You mention being on inuslin shots, i guarantee that your diabetes would improve and any mprovement reduces your risk of complications. if you lose weight and are able to ncrease your fitness levels- it just has to imporove your cardiovascular status. I still have about 90 to 100 to lose, i have lost 125 so far and i am wheelchair dependant- since losing weight, my diabetes has gone, my BP is normal, my cholesterol is better, my joint pain s better and best of all, i am an amputee and haved not had a prosthesis for about 5 to 6 yrs, i was considered hopelss because of my size and then i have ms that affected my remaining leg I i need an above knee prosthesis. a few weeks ago i got my first leg for yrs and can walk about 50 meters at a time ( total of about 250 for the day) may not sound like much but it is something i would never have done without losing the weight- its not a miracle, but the and does help to improve other helath conditions but do not forget that being morbdly obese is a potential killer but long before t kills you , it is likely to rob you of your independance- that was the push i needed to make this work. i had failed to lose weight with the band, then i woke oneday unable to move my leg, feel it or stand on it, i could not even transfer from cahir towheelchar- at 385 pounds, i weighed too much for others to help, that is embaressing! i was luckly my leg imrved rapidly and while its not as string as t was i can transfer even on a bad day now- but that short period when my ms flared up gain was enough to say watch out! there are worse things than premature death due to weight and for me loss of my independance was the thing feared most. I have lost 125 since nov last year

Go to this website and go to the forums and ask Dr. Trace Curry who is my doctor and he is world reknown and done many many of these and with bmi's the same as yours and he answers alot of the complication thread questions on here. He really is fabulous. He has a office in Cinci and a new office about 30 min.s from Cincinatti.

Here's his addy:

Trace W. Curry, M.D. Lap Band Surgeon :: Home

LOL I just read this, and was going to suggest she look you up Jack!!!

Kat

Hello Everyone,

I attended my first seminar yesterday in Columbus, Ohio. The surgeon speaking was Dr. Patricia Choban and I must say that I am a little discouraged by some of the things that were talked about.

She stated that only 65% of people with type 2 diabetes (that's me ) are cured and that is 2-3 years out from being banded.

Also, she stated that for those of us who's BMI is over 50 (that's me again) may not be candidates for the lapband due to the laproscopic procedure itself.:cry????

I don't understand this as I have had 3 laproscopic surgeries done without any concerns about my size hampering the procedure.

Now I have been thinking about the gastric bypass and that scares the heck out of me!!!

Don't get me wrong, I don't want the surgery just for this reason but I would give anything not to have to take 4-5 insulin shots everday, test blood sugars 6-8 times and so on and so forth.

Can someone please shed some light on this for me? I am also going to go to another seminar at Ohio State University so I am definitely exploring my options.

This forum is so helpful and I value all of your opinions.

Thank You

Stats and studies disagree with the diabetes claims. There was recently a study done that showed amazing results! It was technically regarding bypass but the comparison was still there. Of people having bypass within a few days (I forget exact numbers) around 90% of patients were able to completely stop insulin and oral diabetes meds. With banding the results were the same but it wasn't immediate as it was with bypass, it came with weight loss. If I can find the study I'll post a link.

Keep in mind, the longer you have been on insulin the less your chances for remission.

That's not to say bypass is better than banding, don't forget some intestinal tissue does grow back and after 18 months to five years you are back to diet and exercise, so keep that in mind.

As for lap and a BMI if 50 or more, I think you'll find that a great deal depends on surgeon skill. My doc has done over 1400 bands and he's never had to revert to an open procedure from a lap due to the size of the person. Actually, he's never had to revert to an open procedure for any reason in the middle of surgery. He's done a 100BMI person, he just did a 70 BMI and he didn't have to resort to open or bypass.

One of the problems with doing a higher BMI patient via lap is that there are trocars placed in each incision. They look like a metal pole about 1' long. These trocars are hollow and they slide instruments in and out of them. Things that look like scissors, things that burn off bleeders, suture material, etc. For people that are extremely obese the metal bars are not always strong enough to hold up the liver. The bars actually bend a bit trying to move the liver out of the way. So they sometimes have to make an extra incision so that there are two metal bars holding the liver up and out of the way so the surgeon can get to your stomach for banding. Usually there is only one incision and one metal bar.

An experienced surgeon shouldn't have a problem with this.

There are times when an open procedure might be necessary such as if you have an extremely heavy liver AND lots of adhesions from previous procedures. Issues such as that. But again, this is why it is sooooo necessary to go to someone who has done *at least* 250 bands. He won't be "practicing" on you, he'll already have practiced on someone else.

There times someone needs bypass vs. banding are verrrrry few and far between. I would guess that your doc just doesn't know how to do a lap band on a higher BMI person.

I'm assuming you have insurance that covers weight loss surgery so I am NOT suggesting you call my docs office for banding, but just for info. Call Nina at Dr. Aceves' office, although he's in Mexico they have a toll free number. Talk to Nina. Just tell her I suggested you call her for info. She knows who WasABubbleButt is. Just ask her if it is possible for a 50+ BMI person to have a lap band via lap procedure.

LAP-BAND,laparoscopic banding,bariatric surgery,obesity

Dr. Aceves is the VP of the Mexican Bariatric Society. He also holds the position of the Secretary for the International Bariatric Assoc. He knows docs all over the world. If you need a referral to a more experienced doc in the states ask if they know anyone. You don't have anything to lose by just asking. I don't know if she'll have that info or not, but again, what do you have to lose?

This is where researching your doc REALLY seriously pays off. You want the best, so get the best. Do your research, ask the possible docs how many people they have banded via lap procedure with your BMI or higher. Get someone experienced that doesn't have to resort to bypass because they can't do it any other way.

I found the link to the study:

Welsh Medics To Examine How Surgery Can Cure Diabetes

I was on diabetic meds, no insulin, and went off of it 6 months after being banded. Haven't had to go back. But everybody's different....

Another thing to consider is that doctors have to give you a picture of the potential complications and pitfalls of the procedure. Some doctors have a very difficult time walking the line of how much "potential bad news" to pass along with the benefits of the procedure and wind up scaring off their patients in an effort to educate them. All surgery is risky to some extent, and there are no guarantees that you will come out on the other end skinny as a rail and medication/medical issue free. I'd say in the long run, if you weigh (no pun intended) the pros and cons, it is a GIVEN that your current condition is not acceptable and could, and most probably will, worsen. Though the alternative has unknowns, it most certainly is a proactive choice in the right direction (at least for me, it was). Kindof a "nowhere to go but up" kindof thing....

Dorothy,

Try to remember that behind every MD there are ten lawyers triple-checking everything said, insinuated, suggested or promised.

Lap Band is wonderful. It will improve your life if you are willing to play by the rules. And there are hard and fast rules, not suggestions.

Everyone's metabolism is different.

Obesity brings with it many problems. Weight loss many benefits.

Your diabetes situation will be changed FOR THE GOOD once you lose the weight. To what extent, no one can guarantee.... but there will be an improvement. You'll see.

By all means, go to as many seminars as you wish to become familiar with the procedure.

Read these posts as often as you can.

They will guide you and help you make the right decision.

Wishing you good health and success in your quest.