Confusion

Although I have pretty much decided to get my band privately, I went to the appointment for surgery on the NHS.  All information being useful.  Now I’m really confused.  The surgeon said I would not be able to have a band: they don’t do them anymore because they have a poor success rate and a high risk of complications.  She said it would either be the sleeve (where a tube is created out of a small part of your stomach and then the rest of it is removed) or the bypass (where they kind of ‘replumb’ you so that food passes straight through the lower intestine – I think…).

I know these two options offer a much higher rate of weight loss – 70-80% of excessive weight compared to 50-60%.  They are both classified as ‘major surgery’.  When I initially talked to P about this, he was very troubled by the irrevocability of having your stomach removed or re-assembled.  I of course had just looked at loss.  But as we talked it through, I could see the advantages of the band:

1. it’s keyhole surgery, it takes 45 mins and you don’t have to stay in hospital.  You are okay to go back to work after a week (versus a hospital stay of a couple of days and a recovery of three weeks)
2. pretty much all the way through, you have to put the effort in – it seems to be a bit like an electric bike: you still have to do most of the work but you have back up to keep you going longer and stop it being so much of a slog
3. but you can eat more or less normally.  Sure not as much but with the other two, for instance, you cannot eat and drink at the same time (and by that, I even mean water).  That’s weird.  And once the novelty wore off, how limiting would that be?
4. And because you can eat more ‘normally’, you don’t have the inability to take in enough vitamins and minerals through food alone.
5. if anything were to go wrong, you can have it taken out.  It feels like less of a gamble.

My hunch is that it comes down to the person at the end of the procedure.  Those two women talking about ‘still eating McDonalds’ or fish in batter and not following the advice to puree for a week weren’t following any sort of surgery rules.  I did what anyone in that situation would do – yes, I googled.  I found an article which said that the loss is actually better over a two year period, and for the reasons I thought – ie that the long term discipline of finding what works and sticking to it is less of a quick fix and more of a long term, slow burner.  Anyway, I will have the other side of the story when I meet a professor (no less) who DOES do band surgery – and would do mine if I do go down that route.

Cynically, I wonder if the NHS are loath to do a process which uses up more precious NHS £s (and, to be honest, I have some sympathy with this).  Because the band is fiddly – after c5 weeks you go back and then the band is ‘filled’ with saline – and sometimes defilled until you reach the magic point at which you can eat a reasonable amount without feeling hungry or throwing it straight back up.  Then it’s a process of keeping that level – possibly fills every month.  It only takes about 15 mins, but you can see from an NHS perspective the admin involved would be a nightmare – and they couldn’t be responsive in the same way, you’d get your appointment for 3 months hence and too bad if that didn’t fit with your needs.

Hoping to address Seren’s point tomorrow, as it’s something I’ve been agonising over (from before you said it Seren, don’t worry!) and in an attempt to not do a post so long it should be in chunks to make it remotely digestible.