This is a hot-button topic for those who have had any type of WLS. There are pros and cons to every surgery, so please take what I am about to write as my opinion, based on my experiences and research and nothing more or less, ok?
Disclaimer out of the way, I had RNY surgery in April of 2005. I researched the different options (lap-band, RNY, DS) available around me starting in 1999 – this was no quick decision for me. What I found was that while some people experience excellent weight loss with the lap-band, it tends to be quite slow (we’re talking averages) and there is a very high incidence of regain. Plus, we’re talking high-maintenance, having to go for fills/unfills regularly to find your comfort zone. While people tend to lose more quickly with RNY, there is still a relatively high incidence of regain, plus all the possible issues with dumping, strictures, etc. The DS is the “platinum standard” the weight loss is tremendous, and extremely quick. The incidence of regain is exceedingly low, there is no dumping, and a person can eat pretty normally from the time they get home from the surgery.
Since I had 200+lbs that I needed to lose, I originally wanted the DS. I was a perfect candidate for that surgery, being SMO and otherwise fairly* healthy. Unfortunately, my insurance at the time would only cover the band or RNY. I interviewed and researched local surgeons, decided on one and had the RNY.
I came through the surgery very well, but had a scare day 3 – my hematocrit and hemoglobin bottomed out as did my pulse and BP. I was prepped for a transfusion and given a volumiser just in case. It turned out to be nothing more than a weird fluke because of where they had drawn the blood, and not a leak or internal bleeding. Once I got home, I was up and about very quickly. I am a fast healer, do not think that I am “typical” – I am not. I lost very very very quickly, due to 1) my surgeon is very strict with his diet plan, and I followed it to a T, 2) I exercised like mad, as I got smaller and could, 3) when my body works right, it works RIGHT. I lost 191 lbs in 13 months and an additional 30 or so in the next several months (the additional really was the result of my gallbladder shitting out and then having a tummy tuck, but I will get to that). I got down to 117, which on me looks “too small” (according to everyone else – me, I liked it) even though it is very much a healthy BMI, but have brought myself back up to a more “normal looking” 130 or so.
Complications:
Having to buy new clothes every couple weeks because my pants would literally be too tight on Monday and fall off me on Saturday.
My gallbladder, which passed all pre-op testing just fine decided to shit out at around 16 months post-op. If your surgeon can just go ahead and take it out when he/she does your WLS, do it – trust me.
Gout. Gout is hereditary, but I had no idea I was at risk for it, as no one in my family ever exhibited symptoms. The only reason we ever discovered I have it is that the things that trigger a gout episode are: 1) rapid weight loss (check), 2) a high-protein/low-carb diet (check) and 3) foods high in purines (beans are a staple for most newly post-op RNY patients, I was no exception, so check). This is treated with a daily regimen of Allopurinol, and I get my Uric acid levels checked regularly.
Excess/saggy skin. This is going to happen if your skin is damaged – if you have stretch marks, you will have issues, no matter how slowly or quickly you lose the weight. I had a tummy tuck to deal with my hanging panni – the insurance covered it. Boobs are pathetic, but they don’t cause medical problems (well, ok, they do – backaches and all, but that’s just because they’re still huge, even after the weight loss). My husband has promised that we will figure out how to pay out-of-pocket for a boob lift/reduction.
Ok, I think that about covers my experiences. If you have specific questions, feel free to ask me via the board, PM or email. Remember, WLS is not for everyone – and is a HUGE decision that can and will affect the rest of your life.