Bypass or sleeve?

[vegas_mimi 23]

I'm sort of confused I don't know if I should get the gastric sleeve or the gastric bypass I have gallstones but they're not bothering me and I have heartburn quite often I was going for the sleeve but heard that the gallstones and heartburn will just get worse but scared to do the bypass because all the horror stories please help me I'm opting not to even do anything I really want to get rid of the diabetes I have and lose weight and be healthy for my kids without one of the surgeries I know it's not possible.

[60Sandy 4]

Newbie here. Unfortunately I can't answer your question because that is specifically why I am on here. The heartburn situation threw me for a loop when the doc told me that it would only get worse if I got the sleeve. I share all your same questions and concerns. Anyone out there who can help?

[teacupnosaucer 445]

Honestly to me as an outsider it sounds like the RNY would be the better choice for you... but I'm not a medical doctor, and I don't know your life beyond this post.

The sleeve can cause nightmarish GERD, which is why they are hesitant to people who already have issues with heartburn. And the RNY has an EXCELLENT track record of putting type ii diabetes into remission. The sleeve, too, but I think the numbers are lower.

As for horror stories about the RNY... there are horror stories for all the procedures! And there are also thousands of people very happy they made the choice to go through with their chosen surgeries. Both the RNY and Sleeve procedures are statistically incredibly safe operations now, so long as you choose your surgeon wisely and follow pre- and post-op instructions to the best of your ability.

If you genuinely think the life you want isn't possible without some kind of surgery, you either have to accept the risk of surgery, or accept your life and try to make it better in any way you can.

I was very, very scared of complications too, well namely I was scared of dying! I have two young kids and the thought of leaving them behind just so I can lose 60 lbs seems terribly selfish when I think of it that way. But I don't think we can make decisions based solely on the worst case scenario, do you?

When I was still undecided, I said "I will join the program anyway, learn all that I can, put my name on the waiting list... and if it's not for me I can always back out at any time." But the longer I was in the program, and after I met my surgeon, I knew I was making the right choice. I am sure I will still be afraid as my surgery date draws nearer, but in this moment I know I'm doing the right thing for myself and my family.

The best way to make this decision is to put aside the horror stories (which are often third hand and exaggerated, let's be real!), and look at the cold hard facts. Read up on the possible complications and the percent chance of having them. Read surgery stories here. And then bring your questions and concerns to a trusted surgeon, who will help you make the right choice for you.

[teacupnosaucer 445]

And honestly, I have met several women (both sleeve and RNY) who have had monstrous complications from their procedures... who still say they would do it all over again and that they are thankful for this second chance at life.

[60Sandy 4]

Thank you so much for your thoughtful AND well thought out reply! All good points. Time for more research and more research and I'm very thankful for this opportunity to reach out to others in the same situation. Now I know why my 18-year-old daughter is on her iPad so long. I've been on it for the last three hours and am just beginning!!

[teacupnosaucer 445]

No problem at all Sandy! I could have written this exact same post a few months ago, so I'm more than happy to take my turn being the one on the other side of the convo haha.

[AjsMom 1]

I had a band done in 2009, waste of time. Then i had that removed because it hurt, had a sleeve done in 2013. Reflux and heartburn was horrible without an Omeprazole to stop it. I am now on my pre op liquid diet day 1 for bypass surgery. Everyone is different but if i had known all this before i would've just done the bypass. Hope this helps a bit. Any questions dont hesistate to ask, hope i can help.

Edited February 26, 2017 by AjsMom

[vegas_mimi 23]

Thaank u all for responding I'm not actually scared of the actual surgery it's the aftermath like they said it's so much different with the bypass than it is with the sleeve as in your daily routine after the surgery and I can follow the pre and post-op obligations to the T no problem with that I just so scared I will be scheduled for my surgery within the next 40 days I did all my testing and stuff I only need to lose about a hundred pounds would the bypass be too much for me I heard you lose a lot of weight with the bypass

[vegas_mimi 23]

Is the down time for the bypass about the same as for the sleeve do you guys know

[teacupnosaucer 445]

20 minutes ago, vegas_mimi said:

Thaank u all for responding I'm not actually scared of the actual surgery it's the aftermath like they said it's so much different with the bypass than it is with the sleeve as in your daily routine after the surgery and I can follow the pre and post-op obligations to the T no problem with that I just so scared I will be scheduled for my surgery within the next 40 days I did all my testing and stuff I only need to lose about a hundred pounds would the bypass be too much for me I heard you lose a lot of weight with the bypass

with the bypass you may have more food restrictions (sometimes only for the first while but sometimes for life), but other than that I think the recovery is much the same, provided you don't have any complications. it's a more involved operation with more steps, but I don't think your recovery as a patient differs all that much? from everything i've seen, rny people follow the same diet progression as sleevers and have to take the same amount of time off work on average. I think they do spent a couple more days in hospital at the beginning, though.

you will not lose "too much" weight with either surgery, not unless something has gone wrong. your body loses the weight it has to lose, then gains a little to find its new set point. I "only" have around 50-60lbs to lose and my doctor considered the RNY just as good a choice for me as the sleeve from that standpoint, so I'd say 100lbs would also be fine. the # amount of weight lost by procedure depends on the starting weight and bmi of the patient. it's not a matter of "every bypass patient loses 150lbs and every sleeve patient loses 100lbs no matter their starting weight". the 400lb person loses more in numbers than the 200lb person, but the percentages of excess weight may work out to be very similar.

the average seems to be that bypass patients lose about 10% more weight overall than sleevers, and they lose it faster after their operation. we don't know yet longterm how the permanent weight loss and chances of regain are with the sleeve vs the bypass.

the main things are that the sleeve has the risk of making gerd much worse, and the rny has the risk of dumping and malabsorption of Vitamins. neither one will starve you until you are a skeleton when it's working correctly and you are following dr's orders and taking good care of yourself.

the rates of complications are pretty comparable, although I think you are right that the RNY is slightly riskier on account of it being the more complex procedure.

what I would do is write a list of pros and cons for both operations, and also write a list of questions for your surgeon (the "what is the downtime for each procedure" one is a really good one!) your surgeon will be able to look at the whole picture of your situation and your health and your goals and be able to advise you on what procedure will be right for you... and also take into account your opinion on the matter, too! but ultimately, both operations will get you where you want to be.

my personal advice to you is that you really need to think long term. will having a shorter downtime with the sleeve be worth it if it means a lifetime of depending on heartburn medication or needing to have a revision? what is the most important thing to you? because that's where the true answer lies: in your own priorities and your surgeon's medical knowledge.

[PatientEleventyBillion 851]

OP are you on any sort of PPI? I would get on those now regardless. I've taken Prevacid and it's generic lanzoprazole for years. When I had a barium swallow done it showed moderate reflux, no doubt my endoscopy will show something to that extent too. For VSG they generally put at-risk people on PPI's of some sort, and I think those already on PPI's shouldn't be greatly affected. Given the little information in the OP and your reply it's kinda hard to even tailor advice.

I will say regarding your response later the hardest part of this are the lifestyle changes required. You MUST learn how to eat different. Eating the same as prior to pre-op diet that got those of us into trouble will just wreck the surgery and will wind up in the same spot as beforehand. Consider this a tool for a second chance -- the real solution lies in the changes one makes.