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Your worry is going to give you a stroke or higher blood pressure if you are not careful. I'm concerned about that so here are my thoughts. At 61, I finally had the RNY. Initially I wanted the GSleeve, but was educated by my surgeon about RNY and that made the most sense, it is well researched, it is done laparoscopicly and if you need the other part of the stomach removed, you can ask your surgeon to do that. The Y portion of the RNY might need to be attached somewhere else. I'm not sure. I had no pain and have been able to tolerate all of my walking and light housework during my 2 weeks off work. I tolerated the clear liquids and the full liquids well and now I am on solid foods and doing well. With RNY you tend to lose more, but it is dependent on you and what you eat. With RNY, I was taken off more than half of the medications I was on, and taking none of my diabetes meds and insulin. Having a fear of the GERD with GSleeve, I also opted for RNY. Because you are already on pantoprazole and still have issues, I would suggest the RNY because there is a higher risk for those who already have indigestion issues or suffer from too much stomach acids. RNY you can't have NSAIDS, but with my arthritis, I am allowed to take it only as needed, and I take a capsule of Celeobrex, and it works fine for my painful arthritis. Just talk to your surgeon about that. Being down 40 pounds already with the GLP1 medication is good, and it will reduce fat on your liver as a side effect. I too have renal problems, stage 3, but was encouraged by my kidney doctor to have the RNY, and yes, the kidney doc also doesn't want me on NSAIDS, but allows me to do so. I need to get down in weight so I can have a hip replacement. Then, I might not need NSIADs any more. I hope I have been able to give you some information and encouragement to re-look at the different surgeries. RNY is just one step further than the sleeve, and with the history of your family, I'm sure the surgeon will be able to compromise and do a revision to the typical RNY as needed. Having stomach cancer history in your family would be one reason to just take the stomach out that is cut off, like in the sleeve and attach the Y end of RNY elsewhere. A modification should be easy to contemplate and do. Just another thought, your surgeon may want to meet with you because the ulcer in your stomach is evident on the series of pictures taken, and wants to move quickly to get that part of the stomach taken out? It is possible? Already having an ulcer starting may also be the reason they postpone the surgery and put you on healing meds, and get you to "calm down" because worry makes ulcers worse too. There are all kinds of reasons and things to factor in, but I would say you definitely need to find out what the surgeon wants to talk about, and go in with some knowledge. I suggest you take a look at some of the YouTube videos by BariNation. You may find out that they help you. I wish you the best, keep us posted after you talk to your surgeon.

there really isn't malabsorption at all with sleeve. There is with bypass - that's why we take more vitamins than sleevers. But the vitamin thing is really second nature after a while - you just go on autopilot. major complications with either surgery are pretty rare. With sleeve, the most common one is GERD, but not everyone gets it, and for most who do get it, it can be controlled medically (e.g. pantaprazole, which you said you're already taking). Some people with severe GERD do revise to bypass, but it's not a huge percentage that have it that badly. But yes - it IS a potential issue. The most common issue with bypass (besides dumping, which about 30% of us deal with (I never have), but that can be controlled by not eating a bunch of sugar or fat at one sitting, which we shouldn't be doing anyway). The second most common is a stricture, but those are an easy fix. They just do an endoscopy and stretch it out. I had one. Happens to about 5% of us, according to the PA in my surgeon's office (if they're going to happen, it'll be within the first three months after surgery - it's very rare for them to occur after that). if you need more time to think about this, though, then take it. It's a big decision. But as SpartanMaker said, you almost never hear anyone say they regretted it. The only regret most people have is that they didn't do it sooner. I had it at age 55. I wish now that I'd done it at least a decade earlier. P.S. I had GERD prior to surgery, so I went with bypass. I know the chance of having it get worse (for those who already have GERD) with sleeve is only 30%, but I didn't want to risk it. Besides, sleeve was still pretty new when I had my surgery, and I was a little afraid of it turning into "lapband 2" - but it's been around long enough at this point that I wouldn't have had that particular worry. It works well and it's safe. But I still would have chosen bypass for myself because I was afraid I'd be one of those whose GERD would get worse.

I wanted to address the GERD fears as well. Overall, I think the number of people that develop GERD after gastric sleeve is pretty low. That said, I personally am a bit concerned when you say your surgeon "pushes the sleeve". Any doctor that pushes one surgery over another is a bit of a red flag to me? I personally would want them to advise on what they think is best for ME, not what's best for them. My surgeon felt like I was pretty likely to develop GERD if I did go with sleeve, so they advised against it due to what they saw on the endo. FWIW, I didn't even have a history of GERD. It might have helped that I went into the process with an open mind and not fixated on a specific surgery? Lots of people are successful with sleeve surgery even if they have a history of GERD, but this was one I wasn't willing to risk personally. Knowing that bypass is often the revision surgery of choice for sleevers that do develop severe GERD, it made sense to me to avoid all that and go straight to bypass.

It always makes me a bit sad when medical professionals that should know better tell you what you can expect from surgery based on averages. Please know, there are no limits on weight loss after bariatric surgery of any kind, thus saying that you'll only get to 300 is in my opinion doing you a huge disservice. Whether you get to 300, 200, or beyond is all up to you and your behaviors post surgery. As you leaned the first time around, bariatric surgery does not fix your brain, so I would strongly encourage you to work with a mental health professional to understand your eating behaviors and how to address your unhealthy relationship with food. It would really be a shame to go through with a revision to bypass, and end up back at 400 again. As far as dumping, some people dump, and others don't. For some, dumping can be a blessing in disguise because it forces them to eat better. Most people that dump tend to dump on either simple sugars and/or fats. The vast majority of people that do have an issue with dumping can manage it well with diet modifications alone. For those that need it, there are some medications that can help, and in the worst cases, there are even surgeries that can help dramatically. My advice would be to not continue to put your life at risk by staying at your current weight simply because you're worried about something that may not even happen.

I a vertical gastric sleeve in 2006. I weighed about 400 at the time and got down to 250, then plateaud at 285 for 10 years. I was happy with that. In the last 10 years, I've gained it all back and am at 400 lbs again. I am close to my pre-op visit to discuss the revision. The weight loss nurse I am working with said this time, my weight loss might not be as significant. I said I was shooting for 300 lbs, and she said that was doable. I'd be happy with that. What I want to know is what type of revisions you've had, and how your experience is different after a revision than with your first surgery. Also, I am concerned if I have the bypass or the DS about dumping. I didn't have that with the first surgery. I could manage if it was occasional and I could control it by the types of foods I eat, but I have heard it can become a constant, lifelong problem.

Hi! Thank you for the detailed questions — I appreciate the time you took to break things down. Here's a full update from my side: 1. Weight Loss Progress: I’m currently losing around 1 kg per month. I know that’s on the slower end post-bypass, but I’m trying to be patient with the process. 2. Goal Weight: My initial goal was 75 kg, and I’ve now revised it to 65 kg. I haven’t updated my profile yet, but that’s the target I’m working toward. 3. Typical Daily Intake: I eat clean, home-cooked food, and I really focus on quality over quantity. Breakfast: 2 eggs and a small side like labneh or some veggies Snack: ½ scoop of whey protein or something light Lunch: Chicken breast or thigh (120–150g) with cooked dhal or sautéed vegetables Dinner: A high-protein meal like steak, paneer, or fish with non-starchy veg I do snack or “cheat” here and there — I’m no angel — but I genuinely try to make good choices most of the time. 4. Caloric and Macro Goals: I was aiming for 115g protein daily, but just yesterday my dietitian told me to reduce that to 65g. I’m adjusting and seeing how my body responds. I try to stay between 1000–1200 kcal, but again, I focus more on food quality than strict numbers. 5. How I Track: I track everything using ChatGPT, not traditional apps like MyFitnessPal. I log my food manually, with weights in grams, and I try to stay mindful and consistent. 6. Activity Level: My workouts have reduced lately. I try to weight train twice a week, and I walk or move throughout the day, but I’ll admit I’ve been slacking a bit. I’m trying to get back on track. 7. Mental State (the honest part): Physically, I look fantastic. But mentally, I feel like I’m failing. I have really bad anxiety that I’m doing something wrong — that I should’ve reached my goal already — and that maybe I’m overeating without realizing it. This fear honestly clouds my progress. I know I’m not alone in this, and I’m trying to work through it. Any advice, especially from others who’ve had slow progress or battled this anxiety, would mean a lot.

GERD can be a possible side-effect of sleeve surgery, but not bypass. Medications like omeprazole work for some people, but severe GERD can lead to revision surgery. Typically these patients are converted to gastric bypass to relieve their issues. There are a few people here that have been through this, so hopefully they'll chime in.

Obviously you need to decide what's right for you. I was in the same boat as you in that they discovered inflammation during my EGD. I had already been leaning toward RYGB anyway, but that sealed the deal as far as I was concerned. My doctor stressed that even though I wasn't having issues with GERD, there was a strong possibility I'd develop issues if I insisted on SG. As far as risk is concerned, all surgeries carry some risk and since RYGB is a more complex surgery, you are correct that some studies show a marginally higher risk profile. Interestingly, other studies show no difference. Keep in mind that obese people are all going to have a higher surgical risk for ANY procedure than a normal sized person. Other factors that increase risk are things like heart disease, diabetes, smoking, etc. Also, surgical experience and the quality of the facilities play a huge role in overall risk. My point is that cross sectional studies showing risk are not equivalent to YOUR risks of surgery. In terms of "convertability", I think my opinion is somewhat the opposite of yours. Technically, RYGB is completely reversible, since unlike SG, nothing is removed from your body. This to me was a huge plus in my decision making process. When we look at revisions, keep in mind that revision of SG due to GERD is pretty common and those revision surgeries basically revise the patient to gastric bypass to alleviate the GERD. I can't speak to your malabsorption concerns since first of all, malabsorption in and of itself is potentially a good thing for weight loss. i can see a concern for malnutrition, but I was willing to commit to a lifetime of vitamin and calcium supplementation. I also try hard to eat a fairly healthy diet, thus also upping the chances that I have no issues with malnutrition. If you are not willing to commit you those things then yes, this may be an issue for you. Keep in mind that while it's less common, SG patients can also suffer from malnutrition. It's actually recommended that all bariatric surgery patients use supplements and eat a healthy diet and I think as long as you do those things, neither surgery is going to be an issue. Best of luck whatever you decide.

From ACS I understand it has more complications. SG also is the most convertible procedure if I ever needed a revision. I’m also concerned about too much malabsorption. I’ll talk with my surgeon, but if RYGB is my only option I’ll need to reassess my personal risks.

I was swallowing my normal pills the next day in the hospital but I was also drinking pretty good. And when I got home I could take my tablets just fine. If you are worried, though, order some bariatric advantage chewables. They taste decent and you can get them with and without iron. I actually took them the first month just cause they are a little lower iron than my SADI specific vitamin and I wasn’t eating as much to stomach the iron. It won’t hurt to have a couple of options on hand. Even if you have auto ship (which if you don’t have that you should look into it once you know what works for you because you save money and it’s one less thing for you to remember) you can skip a shipment anytime if you end up with too many vitamins. Also the bariatric advantage calcium chews are a good alternative to tablets and they are quite tasty (like candy). I still take them because I like them. They are a bit pricey but for the first month you don’t have to worry about swallowing issues and them being individually wrapped and not needing a drink is pretty convenient. I just keep a handful in my pocketbook and they are always with me when my alarm goes off. For the multi vitamin I use the procare health They are quite complete and reasonably priced. On their site you can do authorship and save some money. My labs have alway been great. Even now while I’m in the middle of chemo and have diarrhea everyday. That is one thing to keep in mind though. What works for me may not work for you. Whatever you do decide to go with take it with you when you go over your labs. You doctor may want to see how much of a specific vitamin is in there. They all have the same stuff for the most part but they have more or less of the different vitamins. If you end up being low in something you can always add that one vitamin but if you high you may need to switch to a different multi that has less a little less of that vitamin. I did the Pro care health multi with 45 mg I believe of iron after my sleeve and post revision I do their multi for the SADI which has higher ADEK and IRON that we need after DS or SADI. Ooh and it’s not a bad idea to eventually have one multi without iron on hand for days where you need to fast like lab days or if you aren’t feeling well and can’t eat enough to take it. I mean for twice a year you can just skip it but I’m doing a lot of labs and stuff right now that require me to miss it so I ordered an iron free and I feel better than I’m not missing all the other stuff at least. Also be sure to tell you Dr you take a BARIATRIC multi because some labs can be thrown off with the higher levels of vitamins. And if something is way off just google that and vitamins and see if that could be the issue to mention to your dr. I think it was biotin and cortisol that was my most recent one that was thrown off.

I have what my surgeon called a mini bypass. Or a sleeve revision with single anastomosis. I had a sleeve in 2021 and bypass in 2024

So update-spoke with a surgeon today who recommended what I have been thinking--hernia repair and do the bypass. I had worries about lack of iron absorption with the bypass but I found out today because I am having to use so much famotidine I basically have very little to zero acid which is necessary for absorption so famotidine is REALLY unsustainable. Also found out on fluoroscopy, my sleeve is not dilated, but I have a kink at the top, which he said is not helping the reflux on top of the hernia. So now I need all the prayers, warm vibes and well wishes that my insurance can do the right thing and not make this a huge pain in the ass to the point I give up and go to Mexico. Also-just to get my ducks in a row--anyone SUCCESSFULLY fight and get a revision covered for use of medical need not weight loss where it normally wouldn't be covered? I'm not gonna lie, I'm not hopeful. Also, does anyone have experience with and can recommend the best Mexico center for sleeve to bypass with hernia repair? Just so I have plan B. Thanks for any insight or help anyone can give!! Sent from my SM-S908U using BariatricPal mobile app

Just had revision to bypass due to stalling for a year and losing 8.5st but still not near target so wanted the bypass to finish my journey, lost 23lb so far and had the bypass 3 weeks ago, no hunger and can get all fluids in with no problem at all

The basic procedure upon which the RNY is based has been done for some 140 years for a variety of GI maladies, so it's mostly a matter of billing codes, and some minor variations in configuration, that make it a bariatric procedure vs. one for cancer, gastroparesis, etc., so insurance shouldn't be a factor if that is what is needed. As to whether the "RNY" is needed for your case is a judgement call; try to avoid self diagnosis and let the doctors make the recommendation as to what is appropriate to treat your particular case. GERD is a classic symptom of a hiatal hernia, and given that you didn't have any particular problem with it for some years post op indicates that it is the hernia and not the sleeve that is the primary problem. Again, let the experts weigh in on this. My preference when considering something like this would be to seek out an opinion from a bariatric practice that is associated with a regional cancer center, as they tend to treat a broader range of GI maladies than a general bariatric practice, and will probably have a wider range of options to consider. If you come across a surgeon who quickly determines that you have GERD and a sleeve, therefore you need a bypass, without looking at any imaging, I would tend to move on to someone else - they probably don't understand the sleeve as well as they should to make that determination. My philosophy is to try to avoid going to a bypass is possible, as it does present some diagnostic and treatment limitations down the line should they be needed as we get older. The blind stomach and duodenum that can't be readily imaged or manipulated endoscopically and medication limitations (of which NSAIDs are the largest class,) are the primary things that come to mind. They usually aren't big deals if that is what is needed, but I don't like giving up options unnecessarily. RNY patients can develop GERD later on, and occasionally (though rarely,) such a revision does not correct a GERD problem, so we're talking more of a statistical improvement rather than an outright cure. If that happens, then where does one go - the bypass is something of a one way street surgically (though is can technically be reversed)? So, my inclination is to go one step at a time and treat the hernia and then go from there is that doesn't correct the problem.

For me the recovery was a great deal worse with the SADI than the sleeve but it was just gas. I think the gas thing is hit or miss and some of us are just unlucky. With my sleeve I was up walking in recovery and home the next day off pain meds and having to be reminded that I just had surgery and to take it easy. After SADI I was literally crying, begging the nurse for more pain meds after five days of not passing gas. It was awful until one morning I passed fade like 5 or 6 times and with each one I felt more and more relief. I honestly don’t think that pain medication does anything to touch the gas pain and if you are unlucky and get it stuck somewhere bad you just gotta deal with it unfortunately. My revision was robotic assist and the sleeve was not. That’s the only real difference. Same surgeon. Same incisions. Similar starting weight. But night and day difference in pain. I did get my gallbladder out with the revision but it was the gas pain that was the issue. After that it was about the same.

I chose the RNY because of the high rate of getting GERD from the VSG, so I don't know why your physician said that it was weight related. While some of it might be, usually it isn't, and with a smaller stomach, the acid can easily go up into the esophagus. If you are able, I would change that VSG and revise to an RNY if you are able, RNY you can't take NSAIDs but the possibility of GERD decreases about 80% of patients. Hope things go well for you, or went well with your EGD, please update us. Wishing you well.

Hey y'all, Haven't posted in a while but I need some insight from the community. I was sleeved December 2020, took RX strength omeprazole for 90 days post op since that was what my surgeon did., had zero issues with heartburn incidences. However, heartburn runs in my family---in the males, I didn't have issues beyond maybe once in a frozen blue moon I MIGHT have a mild case that 2 Tums fixed before surgery. Fast forward a couple of years-heartburn incidences starts getting worse/becoming more numerous, would get up choking on acid if I laid down to soon after eating and everything seemed to cause it. Water, protein shakes, sugar/no sugar, etc it's just stupid. I had a bad attack of pain and nausea a few months ago that honestly had me worried about a heart attack but ended up with a CT scan and was diagnosed with a hiatal hernia--the ER doc I saw said my surgery site/stomach looked fine though. I have regained about 35-40ishlbs from where I was but I have maintained a loss of close to 80lbs. In order to survive mostly comfortably, I am living off of a lot of days multiple famotidines sprinkled through the day. Sometimes NOT eating also causes heartburn. I'm over it 120%. Here's my question---my current insurance covers NO bariatric surgery for ANY reason. Should I pursue JUST the hernia repair in the US or should I look into going to Mexico for a revision to the Bypass with maybe also a hernia repair if that's offered? The reason I went with the sleeve in the first place was my already mild anemia that is genetic-runs in the family on the women's side unfortunately and I didn't want to contend with possibly getting really anemic or not being able to keep up with the nutrition/vitamin requirements but I can't live with this heartburn issue for another 50-60+ years (currently 35 years old). Thanks for anyone who wants to give me some thoughts/input!

So as I mentioned in my last thread, I had VSG in 2014. I did quite well for a decent amount of time but after really losing focus of my diet and lifestyle I have had significant regain. I have literally had GERD my entire life. When my surgeon initially told me that VSG WAS an option, I decided to go ahead with it thinking it was a much 'safer' option than RNY. He did reassure me that the GERD I had was directly related to my significant abdominal weight and that with weight loss it would subside. It DID, and eventually I went from a double strength PPI twice a day to a H2 blocker (at my lowest weight) a few times a week. I thought I was over the moon with this! However, fast forward about 4 years and now my GERD is worse than ever, I literally have productive reflux now. I will be sitting and talking to my husband and what I ate a couple hours ago will just shoot up to my throat without warning (I just read another thread saying this same thing). I get it SO bad when I lay in bed that I will run to the bathroom and literally spit out acid. When I had my VSG I had a hiatal hernia repair too, and I was under the impression that was a permanent fix but i'm thinking maybe not. I have EGD this Thursday and frankly, I am petrified scared of what she will find. I'm not worried about my sleeve but I AM worried that there is irreversible damaged to my esophagus or God forbid, esophageal cancer is found. IF I am found to not have anything significant, I've decided to go ahead with a revision for my longterm health. I have been on PPIs for decades. I want off of them. And I want to conquer the regain.

I never see anyone as far out from revision as I am (5+ yrs) post here anymore. Where are all of our Vets? Go with a surgeon who does a lot of revisions if you can. They may have more experience with complicated anatomies. Good luck!

I'm an old VSG Vet, had my surgery in 2014. Initially lost a successful amount of weight. had some serious 'life' events- change of job, change to night shift, loss of parent, went to grad school and graduated, went to a second grad program, changed career path, etc. I was told in 2017 I had a serious metabolic issue with my liver and that helped me really get focused, went to keto and lost all the regain I had plus much more, resulting in 100lb total loss. Since then, though, I've regained probably 50-60 lbs. I still feel some restriction which is great. Long time issue has been GERD, it was severe PRE surgery but my quite renowned surgeon assured me that with the weight loss, the GERD would subside. It did. But with the weight gain over last 2 yrs, it's back and BAD. I have EGD and colonoscopy coming up in a few weeks to assess the damage. I'm very scared due to the ongoing severe nature of the symptoms I'm having. I'm a healthcare provider so I know all of the 'things' that could present. Because of all this, I'm heavily considering a revision. I have been on PPI for over 20 years. While my magnesium is fine, my bones are already having a lot of issues AND I'm scared to death of the brain effects. What should I consider with revision, same doctor, different doctor, etc? Also I know that weight loss can be slower, but what type of rate of weight loss can be expected? Lastly, what kind of time off from my career can I hope for? I took 6 solid weeks with my VSG and it helped get my brain, behaviors etc really corrected before going back into the workplace.

For me it has been a life changer. I had the sleeve and lost weight but not as much as I had hoped and then I gained it right back plus some. Never did have the metabolic changes or the changes that made it a little easier to eat healthy so when I got done with my SADI revision I know right away that it was going to be different this time. I mean I still want pizza and burgers but I don’t hate chicken and fish now either so it makes it a little easier to make the healthy choice most of the time. I also exercise a lot and I think that has made all the difference in my commitment to my new lifestyle as well as My mood and overall health. Obviously I can’t say I know if it would have been better or worse with the Bypass but statistically as a revision the SADi does provide more loss and a more durable loss. Of course it is never so not as much long term research has been done and bypass is the tried and true gold standard but as a revision the loss is statistically less than as a virgin surgery. I think for me it was a perfect fit but you will want to keep in mind that you need to understand your surgery well enough to explain it or call your surgeon and ask them to when it is appropriate. Most of my doctors have never heard of it and when I was about to get an endoscopy/ colonoscopy done and the dr hadn’t heard of it I called my surgeon to see if that was okay and he called to explain my anatomy to them. Another thing to consider is whether you surgeon is resleeving your stomach. Mine did not. He said the difference in weight loss was not significant amount to take the risks that come with reducing the pouch. Something to do a bit of research on to decide if it’s worth it to you. If you have any specific questions about my experience let me know.

I first came to this board in March of 2022. I had my 1st surgery (sleeve) in May 2022. I had my revision to bypass (due to A LOT of complications with the sleeve) in June of 2023. Since then I have been complication free. But I was struggling to maintain my weight. I was put on a diet and exercise regimen to gain and then maintain my weight. Well, my metabolism finally sorted itself out, but I wasn't paying attention. I was supposed to weigh myself once a week to see how things are going. I went 4 weeks without weighing myself. And I was just eating whatever I wanted in hopes I would gain. And boy oh boy, I did gain. I went from 176 to 190 in 5 weeks. That shocked me, because I wanted to get to 180 - 183. Now I have to stop eating willy nilly, get my diet back on track, and focus more on my workouts. I became lax with what I needed to do and I found myself going back to old eating habits. Examples include eating whatever I wanted, even when it went against my diet. Not working out as much as I was supposed to because I was tired or didn't feel like it. Eating when I was bored. Eating something because it's there, not because I was hungry. Grazing all day and night, which was ALWAYS my issue. I'm telling you all this because I've seen so many posts where some of you guys really beat yourself up for messing up. You're afraid you'll undo all your progress. I admit, that has creeped into my mind a bit, but I remind myself that I know what to do and what not to do. I know how to get back on track. And I know how to give myself grace while still holding myself accountable. It's just a matter of doing it. So I'm going to course correct, get back to the proper diet and exercise routine, and really work on my eating habits. Just know that EVERYONE can slip up. It's not the end of the world....even if it feels like it is. Just own up to your mistakes, correct your actions, eat and exercise properly, and it'll all be ok. And with that, I need to go work out. Have a good one, and wish me luck that I get this sorted.

I also take prescription NSAIDS due to significant back issues, so I initially thought I could not go with bypass. However due to the risk of GERD (symptomatic and verified by endoscopy), my doctor did not recommend sleeve. The resolution was to go ahead with the bypass. With my doctor's blessing, I have continued to take the NSAIDS and have been successful because she also prescribed a Proton Pump Inhibitor for me. If you have any history of GERD, it would be best to at the very least have an endoscopy done to make sure you are still a good candidate for the sleeve. I don't know what the overall revision statistics are, but there sure are a lot of folks on here that initially had sleeve and had to get a revision to bypass. Some of those were due to poor results, but a lot seem to have been due to GERD.

I am...now. I had a sleeve in 2022 and had SO many complications and I was miserable. I had a revision to bypass in 2023 and honestly, it's been amazing. I 100% love that I had the revision. I recommend the bypass to everyone. It literally solved all my issues. And I'm so thankful that I got my life back. I take meds for severe anxiety, for MS, and for lupus. The only real issue with meds are extended release with the bypass. But if you can find a way around that then you'll be fine.

I appreciate all the advice and kind words of encouragement. I bounce between the scary feelings I have about eating and being excited to lose weight and be a healthier me to enjoy life with my family as much and as long as I can. I was and am just a little overwhelmed because I initially went to my surgeon about the hernia repair. He informed me of this sleeve-to-bypass revision that would be in my best interest which I was not expecting. Hence, this isn't so much of a weight loss journey for me as it is a quality of life journey, With that being said it brought me back to confronting my unhealthy relationship with food and took me back to a time after my sleeve in 2009 where the smell of food would take me into an anxiety-riddled panic attack. All the byproduct of not taking the appropriate steps in getting my mind right before the procedure since I went to another country for my initial procedure. The hernia repair to me has now taken a back seat to the lifestyle changes needed to move forward with the bypass and everything that entails. This time I hope to do it a little better and taking the appropriate steps to making my lifestyle change more healthily. It's still very early in my journey. I don't have a date yet. Tomorrow is my initial consultation with the registered dietician and nutritional counselor and hopefully I will feel comfortable discussing my fears of failure. Again thank you for the advice I am truly humbled.