Band over Bypass

[sunflowerloaf]

So I made the 8 hour trip to see my original Dr and we spent 2 hours going over everything. I have late dumping and reactive hypo. The meds I've tried don't work so they said they have cases like mine where they put a band over the bypass and it helps. All I can tolerate is meat, greens and almonds and continue to lose weight. IM wondering if there is anyone on here that has had this? Did it relieve your symptoms? Where you able to eat milk products and fruit again without dumping? I'm going back in a couple weeks so just trying to figure this all out and so sick of being sick

[larra]

Band over bypass makes no sense to me in general, and esp for the type of problems you are having. The band won't change the anatomy that is causing the problems, which is the direct connection between the pouch and the small intestine. That will stay the same. It will not change reactive hypoglycemia which again is related to that anatomy. It will not improve lactose intolerance, and most likely the issue with fruit is the sugar in it, and it won't change that either.

I have not yet seen any formal studies that document results of band over bypass. Most of the time it's done for people who either haven't lost enough weight or who have regained significantly, and I don't know if anyone even knows if it helps for these issues. The only advantage I see for this is that it's easy for the surgeon to perform, unlike revising your RNY to the DS, which is a complex and challenging operation that only a few surgeons have the skill to do.

So easy (in the greater scheme of things) for the surgeon and lower surgical risk for you, but no way to predict the results, and if it doesn't help you, it will just create more scar tissue and more difficulty for any further surgery you may need.

I would recommend that you consult with a surgeon who knows how to do RNY to DS revision and get that person's opinion. Ask specifically if they are seeing patients who have tried band over bypass, as well as whether or not they feel revising to the DS would help you. Some of these excellent surgeons can be reached by email or even phone, at least as a starting point. I don't know where you are so I'm not sure who would be closest (though it sounds like you are travelling anyway) so I'll recommend that you start with Dr. John Rabkin in San Francisco and Dr. Ara Keshishian in Glendale (a suburb of Los Angeles) and go from there. Bottom line, you do have other options, probably better options, and you need to be informed about them before you make any decisions.

Larra

[Deleted]

Why would BOB help dumping and (especially) reactive hypoglycemia? Makes no sense whatsoever to me.

[graceepooh]

First I do not have the bypass but I do have the band.

Some people like the band but it has been a nightmare for me. There are many things they do not tell you about the band. Please do your research about complications and damage the Band can do to your stomache.

Best of luck to you.

[Deleted]

PrettyGirlbounce almost died from complications of BOB. She is on this site and will probably chime in soner or later.

I too looked into this for a very brief time and decided on RNY to DS revision. I spoke to 3 surgeons the first one wanted to "tighten-up" my RNY. I though great it worked for me before right? I had 2 office visits with him. By the 2nd we had spoken several times on the phone. He finally said he was not sure how effective it would be. The other 2, Dr. Keshishian in LA and Dr. Rabkin in SF both without hesitation recommendd full revision to DS. I traveled to SoCal in Dec.

I am about 9 months from surgery and at a normal BMI. However all has not been smooth sailing. I had a tiny tiny pouch with marginal ulcers, which Dr. K knew going in. I had complications and developed a leak while in the hospital. I tell you this not to frighten you it can happen even in virgin surgeries. I knew this going in so should you...however I also knew I was doing the right thing. I was still questioning my decision up to about a month ago. Now 9 months later I can say I would do it again. I feel pretty darn good.

Please look at every option before you make your choice. Be aware some Dr's will recommend what they can do and not what is in your best interest.

Good luck and keep asking questions.
Whitney

[angelcake]

And don't be tempted by the ROSE or POSE technique as people typically lose about 20 lbs before the regain starts. I don't imagine it's ever possible to take it down either.

[sunflowerloaf]

Thanks guys I have been looking into all my options. i have talked to Dr rabkin office and Dr k office. I was told my insurance does not cover the DS and neither of these Drs. I do live in CA so dont have to travel to far. I do not have the amount of money they want. We are living on one income since I've been to sick to work cant afford no more loans We both are paying back student loans and i have 2 teenagers. There is just no way I can do it. So we drove 8 hours back to my original surgeon Dr Owens which is one of the best in CA he does not do DS and he is really trying to help me. He at first said feeding tube and if it makes me better then a reverse than called and said there are case studies out there where the band has helped. My dumping is way worse then the reactive hypo. I live daily and a few items. I just fill like I have to try something. At this point I would even take a reverse. i continue to drop weight each week. Dr Rabkin office also said they were not to sure do to my weight being 133 now. So I just don't know I feel hopeless at this point..

[PrettyGirlBounce]

Hi Sunflowerloaf!

I am Lisa and I was the unfortunate victim of a band-over-bypass. I am SO glad you are researching your options and seeking information and opinions, because I would hate to see you go through what I and several others I know have endured. I am eager to answer any questions you may have and share my experience with you if you would like to chat. I am feeling really under the weather today so for now, I will copy & paste here my introduction post when I joined this site after my revision 5 months ago. Please keep in mind I was a fresh post-op and have since healed fully. This is THE best I have felt since before my original RNY surgery 10+ years ago. I can finally eat like a normal person again and it doesn't suck! So brace yourself....here is my story:

"Hi there! I'm Lisa fka LisaBeezee on OH.
In a nutshell, I had my RNY in 2002 which got me to goal and beyond. I maintained that loss for over 5 years. Then, I lost restriction and the weight crept up on me. At a point I was feeling out of control and longing for that restriction I had during the honeymoon phase of my RNY.

In May 2009, I had a band-over-bypass at which point I considered myself a happy bandster. The band did its job and was everything I had hoped for and more. I got to my goal weight and that has really never changed. My problem with the band goes WAY beyond lack of weight loss. SO here we go...

One evening, I started feeling faint and thought it was low blood sugar or something along those lines. 12 hours later, I passed out and cracked open my brow bone. By the time the ambulance got to the hospital, my cbc was 6.8. An endoscopy showed nothing wrong and after a few days of blood transfusions, I was released. This was my first of many internal bleeds, hospitalizations, blood transfusions, diagnostics and being diagnosed with a bleeding ulcer (which they would cauterize and send me on my way) ...and by many hospitalizations I mean 15+, the longest being an 8 week hospital stay followed by a transfer to a long-term care facility for an additional 3 weeks last year. I was in constant pain and had no quality of life. Period.

I contacted Dr. K and scheduled a consultation since I had heard and read such rave reviews and stories of successful revisions. I was in pain that day too so he wanted to do some diagnostics right away to see if he could figure out the location and source of the ulcers. It wasn't good news. I went to the office on March 29th expecting a consultation and ended up having emergency surgery 13 hours later. In recovery, his exact words were "When I opened you up, it looked like a bomb went off in your stomach." There were over 50 marginal ulcers (no, that is not a type-o) among MANY other obstacles due to my RNY and Band.

An excerpt from my operating report: "Over two hours of time was spent dissecting the left upper quadrant, freeing the dense adhesions that had formed between the band, the left lobe of the liver, anterior wall of the stomach. At some point, the adhesions were so dense that the decision was made to access this from the lesser sac by first taking the short gastric and the gastroepiploic vessels down from 5 cm proximal to the pylorus all the way to the splenic hilum. The entire remnant stomach was mobilized into the wound allowing identification of the retrocolic/retrogastric Roux-en-Y limb extending to the gastrojejunostomy anastomosis. With this in place, the band was identified just above the gastrojejunostomy anastomosis, however, on the anterior surface there continued to be dense adhesions that required very tedious dissection, one layer at a time, using a 15 blade on a long knife handle. Eventually the band was identified on the anterior surface. The buckle was located, unbuckled and the band was put in an antegrade fashion and the accounted for outside the abdominal cavity."

The point of my displaying this is to show that he literally had to DIG my band out which had adhered to my liver and stomach. This doctor saved my life. After a week in the hospital (and a VERY unexpected visit there from a stranger-now-friend named "girlrocker" who Dr. K called to my rescue <3 <3 <3), I was released to go home.

I still have my feeding tube and will for another month or so. I am still angry that my former love affair with my band was a complete and total fraud. I am still a complete and total emotional wreck. I am still in pain due to the severe trauma endured during surgery to get this band and port out...but I am alive...and there is finally an end in sight to the pain I had become accustomed to.

So hi. I'm Lisa. I am a new DS'er...and this is my story."

Read more: weightlosssurgery.proboards.com/index.cgi?board=general&action=display&thread=106&page=11#ixzz2eEvi2UjL


Anyhow, this is some more food for thought. Feel free to PM me if you wish - again, I would love to help in ANY way I can. Understand that you are not alone in this and we are here to support you!

[sunflowerloaf]

Hi thank you so much for your post. I have talked to my Bariatric yesterday and stressed that I do not feel that the band will be good for me and I do not want to have a surgery just to have have another. So he had also recommend a feeding tube if my symptoms go away he said it would be a revision to a sleeve or a reversal. I would much rather try the tube its not like eating is fun no more anyway and that way I can see for sure and than go from there. I so wish I could have seen DR K as he is 4 hours from me but the lady on the phone said insurance was a no go for the DS and cash would be 28500 for this so I guess I'm very limited. But thanks for your post and glad to here you are doing better now.

[Deleted]

We have some very experienced insurance folks around here, so maybe there's something one or more of them can do to help. If you are so ill as to need a feeding tube, I suspect a case could be made for doing ONE procedure that will be more likely to really fix the problem....Don't know if it would get you to a DS, but it might get you a revision to VSG.