Help! Need input and Advice!

[AbacoRaveness 44]

Hello all,

I have been pre-opping for bariatric surgery since March. I've been doing my supervised diet, psych eval, the whole thing. I had my "step 2" appointment yesterday where I discussed the surgical options with my surgeon. He does banding, sleeve, and bypass.

When I started out I was hell-bent on bypass and was still in favor of it as of yesterday, but now I'm stuck! I said absolutely not to the band and my surgeon said no one in his office would ever argue with me on that. But, he said if he had a friend that was my age (28) and my BMI (43) with my goals, he would recommend the sleeve over the bypass.

I am 28 now and have been fat my WHOLE life... seriously... came out of the womb this way and my mother has never let me live it down. Even as a child I was overweight and couldn't lose it. Then when puberty came along, I was soon diagnosed with PCOS which only complicated things further. My mother has a history of thyroid dysfunction and both sides of my family have history of diabetes, heart disease and stroke. I, fortunately, have none of those things yet and would like to keep it that way. That is goal #1 for this surgery. Goal #2 is to be able to do all of the activities that I've always wanted to do, but couldn't because I was too heavy.

I was set on RNY because thought that the malabsorption aspect would help with my PCOS and the associated insulin resistance. My GYN was overjoyed with the concept of RNY and said that PCOS patients have fantastic results with it. There are also several scientific articles that back it up. I haven't been able to find any scientific papers talking about the sleeve and PCOS, but I see from some forums here that some people have had equal success.

My other issue, and I don't know if this is related to PCOS or some other genetic flaw but, I CRAVE sweets. My mother is like this too. She bakes something every day and eats it just because she wants to, not because she's hungry. Fortunately for her, she must have the metabolism of a hummingbird because she never gains weight! I, on the other hand, work incredibly hard to limit my portions and my intake to once a day or less and can't keep the weight off! So, the "dumping" associated with RNY seemed like a good conditioning mechanism... "don't eat this, it will make you feel icky!" rather than "Sugar makes me feel warm and fuzzy inside!"

From what I have read it seems that with the sleeve you should, although not neccessarily mandated, limit carbs. Will this be a serious issue for me, perhaps limiting my weight loss, if I have some kind of weird sugar addiction? I know that either way I will have to break this addiction; I guess my reasoning was that it would be a little easier to do if I got nauseated from it. Sad maybe, but effective?

I'm also seeing that complications tend to be fewer with the sleeve, but I'm worried that if I choose it based solely on that I may not be able to achieve the results that I want.

There are pros and cons of both and I just don't know which to choose. I know I have to make the right decision for me, so I'm doing my research but I would love to hear your advice and opinions on sleeve vs. RNY based on my history

Thanks in advance to anyone who has taken the time to read all of this mess and respond!

[skyblew 0]

I had the sleeve on Aug 4th (one week ago). I am regretting my decision already, that is only because I am one week out and miserable. My stomach with the sleeve is so small I can't even drink a few ounces without pain. I am told that will subside. I have lost 16 lbs in one week. I am a nurse and didn't want a malabsorption procedure. I am glad I didn't choose that. With either procedure, you can stretch it out again, so you have to learn to eat differently. Believe me, I have learned that already in a week. I'm probably not the best person to give advice since it has only been a week. But what ever you chose, be ready for the biggest change of your life.

[DESERTDOC 3]

Here was my thought process:

Band: You can theoretically eat a one pound steak for a meal, it will just take you 2 hours to do it, and you must chew it very well. Your stomach is still the same size. I did not want a foreign body with sutures to break left inside of me. Then I read about bands eroding and about a 50% removal rate at 5 years.

RNY: Not my real stomach, dumping syndrome, too many long term care things to think about. Man created pouch out of something that should not be.

VSG: No foreign bodies, my own natural stomach, removed the part that creates Ghrelin. My own body part, just much smaller, that is it. I can still eat most everything I enjoyed before, except I am eating much much smaller amounts.

Each one has its own pros and cons. The above is just what worked for me.

Regards,

Desertdoc

[PdxMan 4,292]

Believe me, you will lose signigicant weight with a sleeve. You are taking a (approximately, different for everyone) 60 ounce stomach and changing it into a 6 ounce stomach. Yes, you can stretch it over the years, but it will really take some effort. My surgeon told me not to worry about it. Without the ghrelin, everything changes. Just last night I tried a bite of a chocolate chip cookie and it tasted like $#!^. I spit it out.

Skyblew is right, the early weeks are hard. I am only 5 weeks out myself. Early on, your stomach is still swollen. YOU JUST HAD SURGERY FOR CRYING OUT LOUD! What is a realistic expectation? Yes, there is some pain, but they give you meds. Take them. No need to be a superhero or punishing yourself. It does get better. Last night I had grilled chicken and onions. Also, a section of watermellon (which was FANTASTIC, btw)

I'm betting Skyblew will change their mind after a few weeks. Although some people do have unrealistic expectations. They force the timeline too fast and run into trouble. Eating a steak or a potatoe a week after surgery. Really ... you think that is OK? We're not the best at being discliplined when it comes to food, but you must with the sleeve. The rules are even more stringent with the bypass.

Good luck ... do your research

[TijuanaPlication 87]

I wouldn't go for RNY as you only malabsorb calories with that for 2 years but you malabsorb nutrients forever! Also many people don't like the idea of having a blind stomach that can't be scoped (ie no endoscope possible on the sectioned off part if you get an ulcer or stomach cancer... I know this is an issue with plication too, but that isn't what we're discussing).

If you're super morbidly obese and are happy to have your bowels re-routed then you can convert to duodenal switch (or have it one stage). Converting from from RNY to DS can be very difficult (which some people convert to when they start to gain back, see here for info http://www.obesityhe...-DS-you-should/).

Note that 2 stage Duodenal Switches tend to lose more slowly (see here for details http://www.obesityhe...less-effective/).

If you get your bowels operated on you've got to be extra diligent with your Vitamins and Protein (I know 100grams is the minimum for women with DS and I imagine it's similar with RNY).

I'm more versed with DS and I know DSers malabsorb 80% of the fat consumed and 50% Protein, so it's less like being on a diet. I imagine this is the same with RNY but only for the first 2 years. DSers also malabsorb some complex carbs (you still have to be carefulish with carbs with any WLS especially refined ones).

BTW stats for Excessive Weight Loss (EWL) is 70% with VSG and 80% with DS. I'm guessing with RNY the stats may be all over the place as you've got to factor in malabsorbtion for only for 2 years and then you've got to change your diet and go low fat.

Remember Carnie Wilson when she was looking fab and posed for Playboy and now she's back over 200lbs (better than the >300lbs she started at, but she's pretty short I think). BTW that wasn't a dis to Carnie, with RNY you just get the tables turned on you around 2 years out and that's why a lot RNYers seek revisions.

Research, research, research, as revisions can be very complicated.

[AbacoRaveness 44]

Thanks for the input everyone. I did alot of research, employed a few friends to do some research and give their opinions, and talked to some doctor friends. There were still pros and cons for each. But, I've decided to go with the sleeve. A few reasons:

(1) AGE: I'm fairly young and I don't want to do something really drastic just yet. Yes the sleeve is a pretty drastic weight loss measure, but at least I'm not re-routing my intestines.

(2) ACTIVITY: A big part of my reason for doing this is so that I can be more active. I worry that with malabsorption I would limit my activities by not getting enough good nutrition.

(3) I can always convert to DS pretty easily later, if neccessary. I plan to work very hard to see that it does not become neccessary. With RNY, that becomes way more complicated.

(4) I want the hormones GONE. I don't want a "blind stomach" just sitting around secreting lots of the nasty little things. Also, I already have ulcers, so I don't want those hanging around where I can't keep an eye on them.

Hopefully this reasoning may help someone else with the same issue.

I'm submitting to the insurance company this week. Hopefully they will turn it around quickly and I'll be able to set a date.

[myrori 55]

Your story and mine sound so similar,, came out fat, pcos, relatives who are skinny. I could not BE HAPPIER with the sleeve! My daughter had bypass and I have lost more weight than her! The sleeve is a tool that allows you to eat less and learn new habits. They bypass leaves a stomach pouch that you can stretch and the malabsorbtion ( as if that sounds appealing) only lasts about one year. The sleeve and new habits lasts for the rest of your life!

[KATEYEZ0208 8]

Wow I was directed to this link and had alot fo the same questions you have and a similar story. I have a consultation with a doctor on Monday and was definitely going to inquire about which wls will impact my pcos in the best possible way. Im looking forward to being sleeved (God willing) I chose to have my surgery next year so I will have my last few months to prepare myself mentally, physically, spiritually for the great changes ahead. Good luck to you and the others. I love the fact that everyone on this site are so willing to be losers together makes me want to dance lol. God Bless!

[smkeller 3]

You seem to be a very intelligent, thoughtful person who is doing the necessary homework. I think that you will make a good choice whatever you decide to do.

Hello all,

I have been pre-opping for bariatric surgery since March. I've been doing my supervised diet, psych eval, the whole thing. I had my "step 2" appointment yesterday where I discussed the surgical options with my surgeon. He does banding, sleeve, and bypass.

When I started out I was hell-bent on bypass and was still in favor of it as of yesterday, but now I'm stuck! I said absolutely not to the band and my surgeon said no one in his office would ever argue with me on that. But, he said if he had a friend that was my age (28) and my BMI (43) with my goals, he would recommend the sleeve over the bypass.

I am 28 now and have been fat my WHOLE life... seriously... came out of the womb this way and my mother has never let me live it down. Even as a child I was overweight and couldn't lose it. Then when puberty came along, I was soon diagnosed with PCOS which only complicated things further. My mother has a history of thyroid dysfunction and both sides of my family have history of diabetes, heart disease and stroke. I, fortunately, have none of those things yet and would like to keep it that way. That is goal #1 for this surgery. Goal #2 is to be able to do all of the activities that I've always wanted to do, but couldn't because I was too heavy.

I was set on RNY because thought that the malabsorption aspect would help with my PCOS and the associated insulin resistance. My GYN was overjoyed with the concept of RNY and said that PCOS patients have fantastic results with it. There are also several scientific articles that back it up. I haven't been able to find any scientific papers talking about the sleeve and PCOS, but I see from some forums here that some people have had equal success.

My other issue, and I don't know if this is related to PCOS or some other genetic flaw but, I CRAVE sweets. My mother is like this too. She bakes something every day and eats it just because she wants to, not because she's hungry. Fortunately for her, she must have the metabolism of a hummingbird because she never gains weight! I, on the other hand, work incredibly hard to limit my portions and my intake to once a day or less and can't keep the weight off! So, the "dumping" associated with RNY seemed like a good conditioning mechanism... "don't eat this, it will make you feel icky!" rather than "Sugar makes me feel warm and fuzzy inside!"

From what I have read it seems that with the sleeve you should, although not neccessarily mandated, limit carbs. Will this be a serious issue for me, perhaps limiting my weight loss, if I have some kind of weird sugar addiction? I know that either way I will have to break this addiction; I guess my reasoning was that it would be a little easier to do if I got nauseated from it. Sad maybe, but effective?

I'm also seeing that complications tend to be fewer with the sleeve, but I'm worried that if I choose it based solely on that I may not be able to achieve the results that I want.

There are pros and cons of both and I just don't know which to choose. I know I have to make the right decision for me, so I'm doing my research but I would love to hear your advice and opinions on sleeve vs. RNY based on my history

Thanks in advance to anyone who has taken the time to read all of this mess and respond!