Bariatric coordinator thinks RNY would be better for me. What to do?!

[Scylla 106]

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.

I'm thinking I should just go with my "gut" and get sleeved, but just wondered if anyone here regretted getting the VSG and wished they had gotten a bypass instead. Any comments would be appreciated!

[BigGirlPanties 957]

I know two people that had the RNY over 10 years ago, and while they are still doing well; they both said, if they had it to do over, they would have sleeved.

Have you told your coordinator of your concerns and that you'd rather be sleeved? You really need to understand the pros and cons from her side.

One of the girls in our office just got the RNY instead of the sleeve because that's what her coordinator told her as well (different dr) ... but she really wanted the sleeve; she felt the overall benefits for long term were better... I am glad I got the sleeve...no regrets!

If you are thinking the RNY is a good "dumping" tool to control your eating; that's not good... but it sounds like you guys need to have further discussion.

Edited January 15, 2014 by BigGirlPanties

[mistysj 1,939]

Lots of people don't dump with RNY and of the people who do, it can wear off over time. Wouldn't it be disappointing if you got it hoping sweets would make you sick, only to find out they don't? Regardless if the surgery you have, you will likely need to learn to control your sweet tooth on your own.

[Catherine707 253]

I agree that picking a surgery because you have a sweet tooth doesn't make a lot of sense! I am 8 months post surgery and have found that the restriction of the surgery was enough to help me control my sweet tooth. A lot of your success post surgery will depend on how committed you are to changing your life. Any bariatric surgery is just a "tool" to help you change your eating habits and ways of dealing with stressful situations.

[NMJG 1,266]

Honey, just my opinion, but I think you need to rethink WLS completely, regardless of the method. Read here and on other boards about how many people regain weight after RNY (and lapband and sleeve, too). That is because WLS is just a tool. It won't keep you from sabatoging yourself. You need to get your head on straight before you attempt this.

If you have a sugar problem, it's really best to address it beforehand. Some thoughts:

• Get on a low carb Atkins type diet asap and stick with it. Once you get past induction phase your need for carbs and sugar is substantially lower. You may find this is all you need.
• Attend counseling prior to getting surgery to deal with food issues.
• Understand how eating slider foods can easily disrupt and delay weight loss with WLS.
• Learn about addiction transferring and how some people with sugar addictions switch it to other foods/alcohol etc. and still continue to sabotage their weight loss
• Really understand how liquid and soft calories can cause you to stop losing and regain weight.

Best of luck to you however you decide.

[Chelenka 827]

I wrestled with which surgery to get too. I was originally going to get the RNY but after learning more about some of the potential effects of the dumping syndrome, which can include hypoglycemic symptoms and heart palpitations, I decided on the sleeve. Although not everyone experiences those symptoms, I just didn't want to take the chance because I already have issues with an irregular heart beat. However, I knew that I would likely struggle with my desire for sweets because I am a sugar addict. While it is true I can eat candy or Cookies I can't eat them like I did pre-sleeve. If I eat too much of that stuff I feel really crappy so it's sort of like the dumping syndrome but not as severe. No one can predict what your experience will be regardless of the surgery you choose. Many people struggle with re-gain regardless of the surgery they had. It's not a cure but a very powerful tool if used correctly. I think you should follow your own instincts but be sure you are being truly honest with yourself about your choice. Best of luck to you.

[Scraglycat 19]

Hello,

I was sleeved December 11...I visited the surgeon and he suggested a bypass because I had diabetes...recently diagnosed, but still diabetes...Bypass is about 4-5% better for diabetes resolution...

I read about both and was very afraid of the malabsorption and greater chance for strictures (blockages) with the bypass.

When I had second visit, I asked for the sleeve, explained my fears, and he thought a minute, and agreed.

I have no regrets. Five weeks out, I am off all diabetes meds, including insulin. I am not hungry, apparently the loss of the ghrelin part of the stomach has helped me enormously.

I am losing weight and have more energy than ever before.

I do think both procedures are lifesavers, and good. But I prefer the sleeve...

My best,

Beth

[TheOldMeAgain 128]

My sister had the bypass. She does get dumping but it doesn't stop her from eating sweets. I guess the same way WLS won't help anyone long term if your not committed to a Lifestyle Change. You'll just find ways around it by ignoring the bad side effects of eating sugary and greasy foods. No matter what I say to my sister about how she shouldn't be eating certain things she tell me to mind my business. Please don't let that be your only reason for wanting RNY. There always a way around things.

[Scylla 106]

Honey, just my opinion, but I think you need to rethink WLS completely, regardless of the method. Read here and on other boards about how many people regain weight after RNY (and lapband and sleeve, too). That is because WLS is just a tool. It won't keep you from sabatoging yourself. You need to get your head on straight before you attempt this.

If you have a sugar problem, it's really best to address it beforehand. Some thoughts:

• Get on a low carb Atkins type diet asap and stick with it. Once you get past induction phase your need for carbs and sugar is substantially lower. You may find this is all you need.
• Attend counseling prior to getting surgery to deal with food issues.
• Understand how eating slider foods can easily disrupt and delay weight loss with WLS.
• Learn about addiction transferring and how some people with sugar addictions switch it to other foods/alcohol etc. and still continue to sabotage their weight loss
• Really understand how liquid and soft calories can cause you to stop losing and regain weight.

Best of luck to you however you decide.

NMJG, what about my post makes you think I should re-think WLS completely? I have been steadily losing weight on my medically supervised weight loss plan. All I said is that I have a fondness for sweets--I didn't say I was out of control and sabotaging myself. I've had a psych evaluation and was approved for surgery. The psychiatrist thinks I am a good candidate for surgery and we discussed that my expectations are that the surgery is merely a tool. She does not think I need counseling for my food issues.

Trust me, I have done a LOT of research on this and am an intelligent, professional person. This was not a decision made lightly or overnight. I was just wondering if anyone else had decided one surgery over another only to be told by their doctor or nurse that another surgery might work better.

I absolutely DON'T want dumping syndrome, so, no, I don't want RNY for that purpose. (Indeed, I don't want RNY at all!) Perhaps the key is for my bariatric coordinator to clarify what she meant by RNY patients having more "control."

Thanks for your comments and advice, everyone!

[gomekast 559]

When I forst began my wls journey, I intended on rny. But I learned more about the sleeve and was sold on it.

If your not comfortable with rny then tell them the reasons why.

I was sleeved 3 months ago and have what I call 'Gloria' the temperamental sleeve. Gloria doesn't like a lot of food....she doesn't like much of anything at all. She's happy when she doesn't have to do much but just hang out with an empty place down there. But my body does need nutrition so she does have to deal with food.< /p>

From what I gather among other sleevers who were sleeved around the same time as myself, is that my results are not the norm.

But..I will say this...I've been in therapy for 8 years at the time of my surgery. What another poster above suggested to take more time for self discovery is smart.

You may think you've got things under control buttt........this head trip post op is not for the weak, timid or those with any sort of disordered eating history.

Regardless of the method you choose, the mental head work..(i.e. what is it about sweets that mskes you love them so much/what do those items symbolize or replace for you) must be dealt with before, during and after the entire process. My therapist has a large practice largely made up of wls patients...and she has stated that those that had no therapy or counseling before and immediately after the surgery itself have been the ones to regain, struggle and have regrets.

This isnt easy. Its the hardest thing I've done. Its a huge journey of self discovery for me. I'm realizing that most of us here at some point and degree had a certain amount of disordered eating, lack of self esteem and lack of self care and love.

Good luck on your decision, ultimately only you can decide. Not your nurse coord. Believe in the choice 110%!

[roundisashape 712]

I'd definitely talk to the surgeon as well. I got essentially the same speech from the PA at my surgeon's office, but the surgeon was very pro-vsg after looking at my records. It might be worth seeing what his opinion is and why, then really sitting down and comparing the pros and cons of both as they relate to YOUR body and lifestyle.

I'm of the mindset that you can be successful with any of these surgeries, and you can fail at any of these surgeries, and if you go in with your eyes open and ready to try your best you'll probably be fine either way.

[NMJG 1,266]

Hi Scylla

No offense meant. What came across to me in your post, whether it is what you meant or not, is that because of your coordinator's comments you were considering RnY because you eat sugary foods, with the assumption that RnY was a better choice because it would more likely make you sick if you ate it and thus "control" your sugar eating because you could not control it yourself. Perhaps this is only my poor understanding of your true concerns.

If, however, my assumption is correct, I recommended a rethinking because this is very difficult and life altering procedure. Even those who think they have researched everything have a number of surprises in store. There are pitfalls waiting for us everywhere, and if one is already anticipating issues before surgery because of a habit they don't think they can give up, then it just seems like resolving those issues prior to WLS is the wisest choice and gives that person the best chance of success.

Too many people don't resolve these before surgery, hence the sad posts we see here from people who keep running into problems along the way, or people who lose fast but their old habits rear their ugly heads and cause weight regain after the honeymoon is over. We all want you to succeed.

Edited January 17, 2014 by NMJG