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Second guessing my decision re sleeve. Sleeve or RNY?



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Hi everyone. I have been completing my requirements prior to surgery since the end of August, which includes 6 monthly visits of medically supervised weight loss with my surgeon's nurse/bariatric coordinator. My last visit with her is at the beginning of March. After that, assuming all of my other requirements have been met they will put in for approval (which is expected very fast with my particular insurance).

I have done a lot of research since even before August about what surgery was right for me and I was convinced it was the sleeve. Liz (the bariatric coordinator) was very honest with me yesterday and said she thought I might not have very good success with the sleeve because I have been struggling to lose weight and definitely have a fondness for sweets. She also said that when she attends the surgeon's office's monthly support group sessions she is kind of jealous that the patients who had RNY seem to have a much greater degree of "control" in their eating. I can certainly use more control in my eating! So now I am seriously questioning my decision and and starting to re-think my plan. I need to decide before 1/31, as I have my appointment with the dietician who will give me a binder full of info and the info varies a bit depending on the type of surgery I choose.

I realize that RNY has been around much longer than the sleeve and that the sleeve was originally intended to just be the first step in duodenal switch surgeries for 500+ lb. patients. However, the re-routing of the intestine freaks me out quite a bit and I am afraid of nutritional deficiencies caused by the malabsorptive aspect of the RNY surgery.

Has anyone else originally planned to have VSG and wound up with RNY instead? Are you glad you did? Regretful that you did? I'd appreciate any and all comments. Thanks!

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I had lap band first and was stubborn to doc being persistent about having gastric. My lap band was painfull the entire yr. I just had it removed Dec 4 and the scar tissue was so bad I would have had a surgery soon anyway. I had gastric on Jan 9. I have friends that had sleeve, a few love it, a few said the acid reflux is killing them and others gained weight back after a few years.

If you have high blood sugar or type 2 diabetes, gastric is the way to go.

Take your time and weigh your options but if someone ask my opinion it would be gastric hands down.

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I was planning on a RNY 6 years ago. I did the diet and exercise thing and had great success (179# loss). I kept it off plus or minus 10 pounds for a year. Then next year I put 65# back on, then lost it again plus an additional 15. I hurt myself training for a marathon and used that as an excuse to work out less and started eating more. I ate my way back up to almost where I was, which brought me back to the surgery option. I wanted the weight to come off as fast as possible and to have as long lasting effects as possible, so I was thinking RNY. I know people who have had both procedures, including my family doctor, and see that the sleevers are having a better time keeping the weight off. My Dr. chose the sleeve for himself and his wife because he was more comfortable with still having an intact stomach and being able to more naturally digest food. Another consideration is that there seem to be fewer complications with the sleeve. My bariatric surgeon's data, and national data shows that the RNY v. the sleeve has pateints lose faster, but just a few percent. The long term numbers for keeping the weight off are also within a few percent. I only know two people that has kept the weight off with RNY and a dozen who have not.. The sleeve people I know have all kept the weight off over 3 years. My surgeon is doing almost all sleeves now because the percentage of excess weight loss is close with the two procedures, and the sleeve has fewer complications.

I did the sleeve because you are less likely to have reflux and dumping. I think the biggest advantage of the sleeve is that most people do not feel hungry. In the 3 weeks since surgery I have never felt hungry and only consume 500-700 calories. I still have to remind myself not to eat just because I am board, but even if I do the amount I can take is limited.

I am losing about 6# a week and that is fast enough for me. I see others on the forum are losing faster, good for them. The bottom line is which procedure is going to give you the best long term results and best fits your lifestyle? For me the sleeve was the obvious choice. I want to be able to eat normal foods but just be forced to limit the portions. The sleeve will be perfect for me.

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I had my heart set on the sleeve, but my NUT convinced me to do the bypass due to my type 2 diabetes. I was freaked out about rerouting my innards as well, but it turned out to be no big deal. I can eat anything and dont dump. You will hear this over and over again...bypass is the "gold standard" of wls, with the most history and greatest chsnce of success. My NUT said her bypass patients do better at keeping the weight off. All that being said, definitely do all the research you can, and talk to your wls team as well to see what your best option is. I was super stressed cause i got talked into switching surgeries at the last minute. I dont regret it for a minute! Good luck to you, please keep us posted!

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    • Alisa_S

      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
      of something and I'm not sure what to do about it. For years the only thing I've enjoyed is eating. We rarely do anything or go anywhere and if we do it always includes food. Family comes over? Big family dinner! Go camping? Food! Take a short ride or trip? Food! Holiday? Food! Go out of town for a Dr appointment? Food! When we go to a new town we don't look for any attractions, we look for restaurants we haven't been to. Heck, I look forward to getting off work because that means it's almost supper time. Now that I'm drinking these pre-op shakes for breakfast, lunch, and supper I have nothing to look forward to.  And once I have surgery on June 11th it'll be more of the same shakes. Even after pureed stage, soft food stage, and finally regular food stage, it's going to be a drastic change for the rest of my life. I'm giving up the one thing that really brings me joy. Eating. How do you cope with that? What do you do to fill that void? Wow. Now I'm sad.
      · 0 replies
      1. This update has no replies.
    • Alisa_S

      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
      of something and I'm not sure what to do about it. For years the only thing I've enjoyed is eating. We rarely do anything or go anywhere and if we do it always includes food. Family comes over? Big family dinner! Go camping? Food! Take a short ride or trip? Food! Holiday? Food! Go out of town for a Dr appointment? Food! When we go to a new town we don't look for any attractions, we look for restaurants we haven't been to. Heck, I look forward to getting off work because that means it's almost supper time. Now that I'm drinking these pre-op shakes for breakfast, lunch, and supper I have nothing to look forward to.  And once I have surgery on June 11th it'll be more of the same shakes. Even after pureed stage, soft food stage, and finally regular food stage, it's going to be a drastic change for the rest of my life. I'm giving up the one thing that really brings me joy. Eating. How do you cope with that? What do you do to fill that void? Wow. Now I'm sad.
      · 1 reply
      1. summerseeker

        Life as a big person had limited my life to what I knew I could manage to do each day. That was eat. I hadn't anything else to look forward to. So my eating choices were the best I could dream up. I planned the cooking in managable lots in my head and filled my day with and around it.

        Now I have a whole new big, bigger, biggest, best days ever. I am out there with those skinny people doing stuff i could never have dreamt of. Food is now an after thought. It doesn't consume my day. I still enjoy the good home cooked food but I eat smaller portions. I leave food on my plate when I am full. I can no longer hear my mother's voice saying eat it all up, ther are starving children in Africa who would want that!

        I still cook for family feasts, I love cooking. I still do holidays but I have changed from the All inclusive drinking and eating everything everyday kind to Self catering accommodation. This gives me the choice of cooking or eating out as I choose. I rarely drink anymore as I usually travel alone now and I feel I need to keep aware of my surroundings.

        I don't know at what point my life expanded, was it when I lost 100 pounds? Was it when I left my walking stick at home ? Was it when I said yes to an outing instead of finding an excuse to stay home ? i look back at my last five years and wonder how loosing weight has made such a difference. Be ready to amaze yourself.

        BTW, the liquid diet sucks, one more day and you are over the worst. You can do it.

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      Officially here for a long time, not just a good time💪
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    • KimBaxleyWilson

      Three months and four days ago... I was in Costa Rica having a life changing surgery! Yesterday we had a followup visit with Dr. Esmeral via video chat and this morning my middle number changed.  I'm down 47lbs and two pants sizes. I can wear a Large tshirt for the first time in like... 14 years! Woot!! Everything is going great. I have zero regrets. I went down to the riverwalk with a friend and walked 2 miles on Monday without even getting fatigued. And no more snoring or chugging pickle juice for crazy leg cramps! I need to go to the gym more... I'm making new shirts next week so that will motivate me. LOL But I'm also just not as TIRED all the time! I have a LONG way to go...but seeing the progress on the scales and in the mirror is a huge motivator!! Thank you all for cheering me on and supporting me!!
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