Weight Loss

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Saturday, October 6, 2012


I'm glad I didn't call this "Gwen's Lap Band Journey" or something like that.  The lap band will soon be history.  I am learning that these days, the lap band is much less favored since the most recent long term studies are showing what I have experienced...only 30 to 50% of excess body weight lost at best.  Many have a lot of reflux or other complications, but I have not.  I just am not losing weight with it.  So, the paperwork has been submitted for revision, it appears that Aetna is likely to approve it since I meet their requirements, and once that has happened I will schedule surgery (on a Saturday, since I am having surgery at my place of employment--I don't like everyone knowing my business.)  I am taking as little time off as possible.  In fact, I plan to be back at work within the week.  I took a lot of time off for my lap band and it really wasn't necessary.  I have no benefit time now, due to issues with my family, and I can't afford to not work.  My job isn't sedentary, but I think I can get my circulating nurses to push the stretchers for me for a week, and beyond that I don't really have much physical work to stress about.

What remains is to decide exactly what the revision should be.  Both of the surgeons I have met with have suggested the vertical sleeve gastrectomy, a popular revision choice from a lap band.  The surgeon who will perform my revision is someone I work with fairly often and I have a lot of confidence in his skill, plus he's a good person.  Dr. D is sure he could perform the lap band to VSG in a single surgery, but if I choose a RNY it might have to be 2.  My thoughts have been that my metabolism just isn't strong enough for a mostly restrictive procedure.  (VSG is considered to have a very small bit of malabsorption involved due to the loss of gastric secretions.)  On the other hand, I know a lot of people with RNY, and it seems most of them have regained significant weight.  Still, the long term studies are still showing 50-70% excess weight lost at 5 years post op.  50% for me would put me at my pre-pregnancy weight--higher than I want to land at, but not terrible.  70% would put me at my lowest lap band weight, which would be fantastic.  So my question is, am I able to be one of the 50-70% people?

My current thinking is this:  if he gets in and sees that he can do RNY in a single operation, do that.  If he's going to have to come back for a second procedure but he thinks he can do the VSG at that time, do that.  The VSG is easily revised to RNY or DS if needed later.  So if I am going to need 2 operations anyway, it makes sense to do the sleeve and hope that's all I'm going to need.  I really, really don't want another surgery if possible.  I have a lot of stuff to do and laying on an operating table isn't on that list.  I'm supposed to be at the head of the bed with the machine, on the other side of the drape.

It's on my mind a lot.  I'm back on the Obesity Help site for the first time in several years.  Things have changed around there, although it seems the drama between the different types of WLS is still there.  And apparently the lap band folks who haven't been revised are kind of defensive about the band.  Whatever.  I don't have time for weird internet forum madness, I just want to make an informed decision about my own surgery.

Meanwhile, Lucy has just turned 2!  She had a rough day today--partly being sick, and I think partly just being 2, and some family stress taking a toll on her as well.  But usually she is happy and fun.