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Trying to decide--Bypass or Sleeve?



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My story is similar to @PdxMan. I too had a hiatal hernia repair and it was repaired during my sleeve surgery. I no longer suffer from acid reflux.

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I am also 28. I need to lose about 125 pounds or so. I'm a bit confused because my surgeon did not tell me that bypass was for 200+ pounds people.

I never said only people that need to lose 200+ pounds go with bypass, but when I was debating both options, my surgeon told me that in situations like mine where no co-morbidities exist (sleep apnea, high bp, cholesterol, etc...) he would recommend the sleeve, unless they had a lot more weight to lose like 200+ pounds because then you would have a better chance of getting to goal faster and keeping it off.

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I recommend a Pro's and Con's list. No one's opinion should make you lean one way or another, of course everyone will tout their choice as the best. But you need to consider any prior health problems you have pre surgery to make a good decision for yourself. Such us, do you have reflux problems? Then the Sleeve is a very poor choice for you. Do you have problems with Vitamins and anemia? Then Bypass may not be your best choice.

Good luck. :)

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Tough decision...just discovering a barret from the egd has my doc recommending the bypass. Im not a bypass fan however. I never ever want to experience dumping and my herniated disk from years ago has anti-inflammatory needs im not so certain i can handle those spasms in my upper back without nsaids. Im unsure of what to do as well. I never even realized till recently that I even had acid reflux.

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Irene, I have also heard that sleeve is not a good choice for those with reflux issues, but I do not understand the reasoning behind it. Like myself, Curvy also says the sleeve cured her reflux issues. Do you know the medical reasons why Drs do not recommend sleeve for reflux folk? Perhaps if the root cause is something other than a hiatal hernia?

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@@PdxMan It seems that majority of sleeved people with prior GERD end up with worse symptoms over time, as the stomach is small and the acids are still as active as they were when the stomach was a normal size. Most Surgeons will not recommend the Sleeve to someone with prior GERD problems anymore.

I of course can't explain the curing of GERD post op Sleeve, there are always exceptions to every rule. :)

Edited by LilmissDiva Irene

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I never said only people that need to lose 200+ pounds go with bypass, but when I was debating both options, my surgeon told me that in situations like mine where no co-morbidities exist (sleep apnea, high bp, cholesterol, etc...) he would recommend the sleeve, unless they had a lot more weight to lose like 200+ pounds because then you would have a better chance of getting to goal faster and keeping it off.

Oh ok.. :)

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I think we all are passionate about the surgery we have chosen/had. Its all about what you want and what will work best for you.

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You've been given some very sound advice in this thread. I'd totally suggest writing a PROS and CONS list and be very honest with yourself.

Good luck in whatever surgery you choose.

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PDXMan

I have GERD... my surgeon said that most of the acid in your stomach is made in the lower part. So, with bypass, that part of the stomach is separated from the digestive track and so no acid comes back up. With sleeve, you still have that lower part of your stomach intact.

I also have a hiatal hernia he's planning to fix.

Edited by Ginger Snaps

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The sleeve was developed as the first surgery for very large people, then to be followed with a bypass. As time went on, statistics showed that the sleeve was almost as effective as the bypass. Now the sleeve is the popular surgery. That being said a bypass does have advantages for some. As another poster said, you can always get a bypass after a sleeve. That would be the more conservitive move.

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I thankfully don't have GI problems. No heartburn or reflux history. From what I am finding out, Im leaning towards the sleeve. Thank you all for your input, I really appreciate it :D

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Initially I wanted sleeve myself and the first few visits my surgeon and I decided on that. Later I did my own research and again had conversations with my surgeon and what he has seen in his experience. He is well known surgeon in NYC and all around the world and I trusted his opinion and he said with my weight which was 210 before surgery with high bp, dm2, cholesterol, pcos, gerd, sleep apnea that I should go for bypass. He did say there has been a lot of success with sleeve but whatever I want he will do. I wanted to get the max benefit out of my insurance and wanted to do this one time only so I moved forward with bypass. After almost 5 weeks I am down to 184 and have no more health issues. I still take protonix which we have to for 6 months to avoid ulcers. Do I regret it? I did the first few weeks but I am now very happy with my decision now. Also I felt sleeve is a new thing vs bypass. But everyone makes a decision on what works best for them. I am sure it will be the right decision for you and your body. Good luck!

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i was in the same boat and had initially explored the sleeve. my initial appt with my surgeon didn't really discuss any of the options, just mostly ALL of the testing involved...

then my family doctor gave me a formal lesson in sleeve/reflux. i already have GERD and take a PPI drug twice a day. so i set my decision to bypass.

saw my surgeon last week for the final follow up and he actually says that he believes the sleeve is better for me because with my GI history, i don't want a blind stomach sitting there sealed shut that can't ever be scoped (I have EGD twice a year due to Barrett's disease).

everybody is very different and the opinion that counts most is your surgeon. have a candid discussion and get his/her true feelings about which fits you the best. also, some insurances will only pay for certain surgeries if you have certain diagnoses...

What is your GI history? Just curious...i want the sleeve but with a recent barrett discovery, the doc is recommending bypass.

I have had GERD since childhood and was formerly diagnosed with Barrett's esophagus in 2003. I have had multiple bleeding ulcers and barrett's lesions biopsied. The issue for ME is with bypass your pouch stomach is the only part that can be scoped in and EGD. the rest of your stomach sits there, functioning and secreting gastric enzymes, but is sealed shut. the only way to get in and see around is an actual surgery to cut open the stomach and examine it.

i have had too many problems to take the chance of just letting it sit there untouched. i would have to have surgeries about every 2 years to look inside the stomach.

this is ME. everyone is so different. bypass can be a great choice even with barretts, but i also have stomach history which adds to the equation...

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    • LeighaTR

      I am new here today... and only two weeks out from my sleeve surgery on the 23rd. I am amazed I have kept my calories down to 467 today so far... that leaves me almost 750 left for dinner and maybe a snack. This is going to be tough for two weeks... but I have to believe I can do it!
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      1. This update has no replies.
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      1. Selina333

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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.
      · 1 reply
      1. LeighaTR

        I hope your surgery on Wednesday goes well. You will be able to do all sorts of new things as you find your new normal after surgery. I don't know this from experience yet, but I am seeing a lot of positive things from people who have had it done. Best of luck!

    • 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.

    • CaseyP1011

      Officially here for a long time, not just a good time💪
      · 0 replies
      1. This update has no replies.
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