sleeve or rny, some thoughts/questions

[Katie Loesch-Meyer 71]

So, I'm currently on the fence with sleeve vs rny. I have GERD. Normally, that would mean I would just do the RNY, forget sleeve, from what I'm reading. However, I do have a hiatal hernia, which he would repair during the surgery. Of course, I had heartburn 20 years ago and no hiatal hernia at that time, at least not that was identified during gi series and endoscopy. So maybe fixing the hernia won't fix the GERD. The surgeon also says he will do a Dor fundoplication to strengthen the LES during the sleeve surgery, to prevent heartburn. So he's not ruling out sleeve. However, when we met one on one, he did say if the reflux was "too bad, and went up really high" he would suggest RNY instead, as the dor fundoplication won't be enough to stop that. So he has me doing an upper GI and manometry before we decide. I did the upper GI, found hiatal hernia this time (wasn't there 20 years/3 kids/70lbs ago) but saw no episodes of reflux. I guess that is common, not to see it even though you have it because it isn't constant? I am scheduled for Manometry on the 14th. Part of me wonders if I should just say, go with the RNY, and lets not chance it. Plus, maybe I'd get better weight loss. The other part of me (probably the more logical part) realizes that long term, Sleeve is probably the safer option as far as not having to worry about ulcers at the anastomosis, strictures of the anastomosis, dilation of the anastomosis, not to mention the ability to take NSAIDs if needed.

What would you do? If it matters, i'm turning 39 in a little over a week, I'm 5'1" and weight 213lbs (naked, in the morning, lol). BMI is 40.

[CanyonBaby 1,852]

I am IMPRESSED! Wow, you really know your stuff, which is great...so many go into this without all the info they truly need. Well done!

As for your decision, I understand that if the sleeve doesn't work, the RNY may be done, depending on your situation. So, have you and Dr. considered this? Just an idea.

You will find ALL kinds of responses on the N-Said thing. Some say it is ok, as my Dr. says, and others say no way. I take Advil liquid-gels with no issues (only when I really need it for the arthritis, though, not too regularly). The best thing there is to follow what your Dr. says.

I wish you all the best, and if you need a buddy, please write!

[Katie Loesch-Meyer 71]

Thanks, I tend to overreasearch, if anything, lol. In fact, whenever a family member needs research done, they just ask me to do it. It's my super power

And yes, we did discuss that I could always convert to RNY later. In fact, one of the reasons he likes sleeve over RNY in general is there are more options down the road. Not as many things to do if an RNY doesn't work out, for whatever reason.

It's just hard, not knowing what is best.

Recovery of an RNY sounds longer too, and I have young kids to take care of. My teen son and mom will help, but the sooner I can be lifting, etc the better. Not sure if that is only my perception, or fact, as far as recovery time.

[mae7365 372]

I also had GERD and a hiatal hernia. He repaired hernia at time of VSG. I did suffer from heartburn for the first couple months after surgery, but it has now resolved and I'm actually not taking any prilosec or nexium as of last week. My doctor never seemed concerned with my acid reflux before surgery. He was pretty confident that it would resolve itself after surgery.

[CanyonBaby 1,852]

To help you after surgery, it is going to be difficult to get your fluids in (especially with the hernia repair...had that, as well), use the Water Enhancer drops. Makes it much easier to get it all in. Shop before your surgery so you don't have to think about it afterwards. Start the day with warm Water (your tummy will have contracted during the night with nothing in it, so it will be unhappy being wakened up with a splash of cold water!!!). Then, when you are onto solid foods, start the day with a couple bites of soft food, for the same reason, then onto the harder/denser foods. You are kinda "priming" the tummy for the other stuff. This has helped me tremendously, and HEY! My NUT actually knows what she is talking about!!!

[WL WARRIOR 690]

I strongly believe that you can lose just as much weight, or more, with the sleeve as compared to gastric bypass. I have lost 110 pounds since my surgery on October 6, 2014. I'm 38 years old and have hypothyroidism, which makes it harder to lose weight. You just need to stick to the guidelines and be consistent. My weight loss has been greater than eight other RNY patients that had surgery the same week as me.

I wish you sucess no matter which procedure you choose.

[sarahbeth3569 95]

If you already have the GERD I would strongly suggest going with the Bypass. There is a chance after the hernia is fixed that it would resolve itself...and I took that chance. While other's experiences might be better than mine, and a lot of peoples GERD does resolve 5-6+ months post-op, those first couple of months are hard (hell...fire burning hell) . I'm in the process of converting to bypass at less than a month post-op. And while I'm ready to be over this GERD, I'm dreading another recovery and re-opening incisions. I think it would be much easier if I was a lot further post -op and my body was more healed so if your surgeon is willing to convert you post-op then maybe sleeve is still an option. ? Good luck with whatever decision you make.