male only Struggling with Second Thoughts

[geronimo 52]

(Just noticed I posted this in the Men's Room - can someone please move it to the General forum?)

Early last year I began researching WLS and decided I wanted the sleeve. I've been set on the sleeve ever since, but in going through the pre-op investigative tests earlier this year, it was discovered that I have very bad acid reflux and Barrett's, so both the bariatric surgeon and thoracic surgeon agreed I wasn't a candidate for the sleeve, and that the bypass was my only option. I really felt deflated at hearing the news, and since then have been on the fence about getting the surgery and struggling with the decision.

To me, the bypass seems much more invasive, with more risks, complications, and more unknowns, such as how nutritional malabsorption will play a role in my life down the road - 5 years, 10 years, 30 years - with brain function, osteoporosis, etc. Ulcers in my pouch. Not being able to use NSAIDs (my mother had bypass surgery and now has bad arthritis, and all she can take for it is Tylenol, which doesn't help her - and I expect I'll too have arthritis as I get older. I already take daily aspirin for blood pressure, and advil is the only pain reliever that seems to work with my headaches.). And while I am all for heavily cutting down on food portions and whatnot, the potential to never be able to eat some foods again feels a little... disturbing? And things like dumping - I don't feel I need that mechanism as part of my WLS tool, but that I'm now being forced into it. It just seems like being changed from sleeve to bypass has added an additional level of worries and possible issues to how I had initially envisioned my WLS journey.

I'm also going through feelings of guilt, like I'm cheating. I've done all the diets and a couple weight loss programs (haven't we all?), and I was successful in the sense that I've dropped from 310lbs to 205lbs, and then later from 280lbs to 200lbs. I've yo-yo'ed quite a bit, but I feel like when I work hard (and torture myself ) I can slowly get it done. Of course, it doesn't take much, just a slip or two, before the weight starts creeping back on. But the thing is, I've done it before. It's like when I quit smoking many years ago - it took me two years to finally quit, I had a lot of failures and slides, but one day it finally clicked and worked. Can't the same be true of just trying to eat healthier and exercise? And isn't that what I'll be doing anyway once I get the surgery? I don't know, I'd love to get the surgery and just move on with my life in a much healthier fashion, but part of me feels like I would be failing myself.

I'm really struggling here - the closer I get the more I'm fearful of the bypass over the sleeve, and the more I'm having second thoughts.

Anyone else go through this, or ever feel like this?

Would appreciate any and all thoughts.

Edited August 2, 2015 by geronimo

[dhrguru 1,238]

I had second thoughts five years ago when i first sought out surgery. I Was unhappy with my weight, but didn't feel strong enough that I needed such a drastic, permanent change. In reality... I just wasn't ready and I'm glad I backed out then. Other factors (wasn't a fan of the surgeon at the time) helped, but after now having done surgery, I knew I wouldn't have be ready for these changes then.

I had bypass in April. Regarding down the road complications...i took a long hard look at family history, knock on wood-- we're a fairly healthy bunch. No one in my family relies in nsaids, sure it may change for me but at least I know it's unlikely. Re nutritional deficiencies due to malabsorption... If I do my part and take my supplements and follow up with blood work as prescribed it shoulnt be an issue. And so far I don't dump, it could change but the'fear' of the unpleasant side effects keeps me on track. Just think of all the complications remaining overweight/obese can add in your life. (Diabetes runs rampant in my family...i wanted to avoid it at all costs)

Your situation is a bit different since you have to wrap your head around a whole new surgery. Second thoughts are normal though... Only do what you are ready for. Maybe just follow the supervised diet for a few months and make a decision at the end of it??

Good luck!

Ugh sorry, didn't realize this was the men only board.

[geronimo 52]

Thanks for your thoughts, dhrguru - I just completed the 6 month supervised diet, and am now just waiting on the final OK from the insurance company and a surgery date. The need for bypass over the sleeve wasn't solidified until just a couple months ago, so yeah, I guess I am still trying to wrap my head around a whole new surgery, doing the research on it (and trying to separate old/bad data from new good data).

[LuckyStar 24]

@geronimo I too am having doubts and my surgery is tomorrow! I am scheduled to have the sleeve. But the fact that this is permanent and taking supplements for the rest of my life seems a bit disturbing. In the end, only you can decide wether to go through with it. The catalyst for me is being told repeatedly that this surgery will "save my life,". That is a very good reason to go through with the procedure. I too have yo-yo dieted most of my life and to no avail, always gained the weight right back. I am at my heighest weight today and have several comorbidities that lead to my decision for sleeve surgery. Regarding the arthritis, you would be taking Citracal (Calcium Citrate) daily (along with other vitamins) and that should take care of your bone health. Hope this helps a bit! And good luck withyour insurance approval and diet program.

[VDB 800]

Your reticence is understanding, this is a huge surgery, a giant step. I had to take it to live, with severe diabetes, high blood pressure, urge incontinence, severe edema, all of which are now virtually gone at the 3 mos post bypass timeframe. I had hundreds of attempts to lose the weight but slowly over the decades crept up to over 422#. I, too, used the NSAID pain killers and Tylenol is a hoax, does nothing for me. The good news is that I don't need it anymore. I have already lost 80#, and look forward to a long life. I don't mind the supplements.

Having said that, I think you should be solid about why you are doing this major surgery. You seem to think you might be able to make it to health without it. Go for it if you can. In alcohol treatment, addiction counselors frequently tell people who are unsure if they are alcoholics to go ahead and drink and see if there are any negative effects...

[sassy14 178]

I, too, was "switched" from sleeve to bypass when my doc found my reflux to be too much for the sleeve. I was so upset I went right from the bariatric surgeon's office to my gastroenterologist and crashed my daughter's appointment. He set my mind at ease-- RNY is the gold standard weight loss surgery. It works.

My surgery was 2/28/13 and I've lost more than 130lbs or 98% of my excess weight. I have blood work done regularly and tweak Vitamins based on that.

Yes, there are some complications but there are many more people without them. I had a ventral hernia that if would have likely had anyway because I had surgery 29 years ago that weakened my abdominal wall.

I am so glad I had the bypass. Best thing for me.

[catwoman7 10,845]

I don't really see how it's more invasive. Both are major surgeries. Unless you're referring to the intestinal re-routing - although that's not necessarily more invasive - it's just an extra step.

some things to keep in mind:

1) RNY has a lot of long-term research behind it as it's the gold standard

2) not everyone dumps - the number I've heard is 30% (of patients dump)

3) ASMBS is now recommending that VSG patients avoid NSAIDs, too

4) Malabsorption problems are supposedly not common IF you keep on top of your supplementation and get regular labs

5) VSG patients take supplements, too - just not as many. I've found it easier than I thought it would be. I take a small handful at Breakfast and a couple at dinner. Then I just have to work in my third dose of Calcium, which I take sometime during the day. Once I add Iron, I'll take that before bed.

my arthritis and headaches have both gotten *much* better since I lost weight, so I really haven't needed the NSAIDs (this was a huge concern of mine pre-surgery, too).

[drmeow 323]

I agree that bypass being more invasive is a myth. In bypass, your entire stomach is still there. If you have problems down the road that are insurmountable, it *can* be reversed entirely. With the sleeve, a huge part of your stomach is gone forever. That leaves a much smaller area, and while NSAIDS may not be a problem for some people, concentrating those drugs in a smaller area could lead to ulcers just as much as for bypass folks.

Re-routing the small intestine is what makes it seem so much more dramatic, but again, that can be reversed if for some reason it becomes necessary.

My GERD has been relatively mild the last few years, but there is no way I want to have a surgery that could potentially worsen it. Not only is it painful, but it can lead to cancer if severe enough.

All that said, there is nothing wrong with taking more time to decide and be comfortable with it. And if you decide to have surgery (of any type) you are not taking the easy way out, any more than a diabetic who takes insulin is doing so, rather than changing their diet. It's a tool and it's lifesaving for many people, and it takes hard work whether you have surgery or not. Best of luck with whatever you decide!

[drmeow 323]

Oh, one more thing - you should read some of the sleeve to bypass revision threads. While I know there are plenty of people who are successful with the sleeve, there are a lot who end up revising due to reflux or other issues, so they might be the best to talk to.

[Bufflehead 6,358]

My apologies posting in the guys' room, since the OP didn't actually want it here I am going to assume it is okay to respond.

I had the sleeve due to some medical concerns that made bypass not the best option for me. Otherwise I probably would have gone with bypass. I know several people who have had it, such as my niece and a good friend, and they have all had great success. I see people at my wls support group with bypass. They are all healthy, happy, active, cheerful people. And they are all doing great with their weight loss!

I also take Vitamin and mineral supplements with the sleeve and will for the rest of my life. I also have to be careful about what kind of medications and supplements I take, since the smaller size of my stomach can affect the way some medications are absorbed. I don't think it it is very different with respect to the bypass. And for NSAIDs, as others have pointed out, many surgeons are recommending against sleeve patients using them. And recent medical studies are pointing out that maybe they are not a good idea for *anyone* to take on a regular basis anyway.

http://www.arthritis.org/living-with-arthritis/treatments/medication/drug-types/nsaids/nsaids-heart-attack-stroke-risk.php

http://www.fda.gov/ForConsumers/ConsumerUpdates/ucm453610.htm

[James Marusek 5,244]

I had RNY surgery 29 months ago. Severe acid reflux or GERD is incompatible with the sleeve. RNY is definitely the better choice here. I had several episodes of severe acid reflux before surgery and none since. I had a number of medical conditions prior to surgery and the main reason why I did the surgery was to get those under control. Within days after surgery, my diabetes, high blood pressure, GERD, sleep apnea, frequent urination problems went into remission and stayed there. I was off my meds. One of the reasons why I liked RNY was that it caused you to lose weight the quickest and produced the deepest weight loss and most importantly had the least amount of revisions. If I went under the knife once, I sure did not want to do it again, and again.

RNY surgery is not like dieting. I tried dieting a couple times and it was a complete failure. After surgery I completely lost my hunger. It wasn't difficult to lose weight when hunger was not constantly gnawing at my bones.

[AvaFern 3,516]

I noticed in your topic you wanted it moved to the general forum, so hoping it's ok for a woman to be responding even though you're in the man's room.

I can understand your concern about being stuck with bypass instead of the sleeve and I would also have a hard time with that. That being said though, you noted that you were successful on your own losing weight and that it just took one slip to start gaining again. Much as the first year or so is like a honeymoon after bariatric surgery, you will still spend the rest of your life counting calories, working out, and potentially gaining weight if you are not aways vigilant. I love my sleeve, but the further out that I am the more I realize that my weight will always be a battle. Every day I wake up and I weigh myself. Then I drag myself to the gym or for a run, I log my food in MyFitnessPal, and some days I still wake up the next day fatter than the day before. If I am not always on my game, every single day, I can now see that I can very easily gain the weight right back.

So, while I am all for bariatric surgery, remember that no matter what option you choose, you can still be a fat person with 20% of a stomach, a fat person with a band around your stomach, or a fat person that has no food routed through their stomach. It's less about the surgery and more about recognizing that you have a tool, which you can use or not use, but in the end, the fight to not be fat is a lifelong battle.

Good luck with your decision!

[Cupcake 801]

Your # 1 Goal is to be healthy I do not see any misunderstanding in that, you need to ask yourself is it really the procedure you are afraid of or the challenge on being healthy? Because it will come down to having a surgery to save your life as well as allowing yourself the opportunity to be healthy as well as get rid of possible health issues that arises from being obese. If you would ave had the sleeve it comes with possible side affects like all things in life there is nothing 100 %. The RNY is the gold standard and if your doctors thinks thats the best thing for your health do to your on going health issues I do not see the issue, I am sorry I a not trying to hurt your feelings but the bottom line is for you to be healthy because doing nothing does not help you. Good luck.

[B-52 7,113]

It really strikes a nerve with me when people feel guilty because it may be cheating or the easy way out.....and they're going to jeopardize their health and life because of that???

SO WHAT!!!

What difference does it make??? The only difference is that it DOES WORK!!! And will CHANGE YOUR LIFE IN WAYS YOU CAN"T EVEN IMAGINE...

Dieting is hard....very hard...so hard I could not do it and succeed for very long. And with every failure I was just digging myself deeper and deeper...

The only regret you're gonna have, 3-5 years from now, is what you could have been instead of what you've became.

Trust me...IT WORKS!!!! And I'm DAMN GLAD I cheated and took the easy way.....it doesn't get any better than that...

[geronimo 52]

Thank you everyone for your responses! They all have been extremely helpful, and it's nice, while I've got all of these thoughts zinging around in my head, to hear everyone's rational insights and thoughts. So thank you!

My parents have been extremely supportive of me in this process, and in talking with them today they pointed out a few examples that parallel my thoughts, such as the example that people recovering from heroin addiction have to take something like Methadone to get through the process, and most say they wish they could kick the habit without the need of the additional drugs. Which, reminded me that when I quit smoking, I had to use a number of tools, like the Nicotine patch, to get me through it. I simply could not have kicked my smoking habit without the use of the patch.< /p>

So, while stomach surgery isn't quite on the same level as taking a pill or applying a patch, they all are tools to help achieve the wanted end result.

Anyway, I'm back to a much better mindset about it all, and just wanted to say thanks to you all.

Edited August 3, 2015 by geronimo