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Need advice:

I am 31 years old and I had lap band in 2011. I weigh more today than when I had the surgery. I am currently scheduled for gastric sleeve in Mexico April 13, 2015 but have been considering gastric bypass.

I don't want to have another surgery. So I need people to offer experience or advice of why you chose bypass over sleeve. I have 120 pounds to lose with 2 small kids. High Blood pressure and in danger of being a diabetic. I do not suffer from acid reflux.

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I'm pre-op, but here was my process.

I considered the Band for years (And pounds ago). My BMI is higher now and my surgeon recommended the bypass for me because of it. But I did do my research.

I didn't like the idea of a foreign object inside of me. Plus I know someone which the band was less than successful. Band was out.

I don't have severe heartburn or acid reflux but I do get it occasionally. I am scared of causing a problem don't have and having to revise later (Which I have no idea if my insurance covers. Bringing me back to...)

The Bypass. I didn't think restriction was enough at my BMI. Malabsorption scares me a little but I think the results will be worth it. Also I wanted the gold standard. If I'm gonna do something, I do it all the way, so to speak.

  • 2 weeks later...

I'm having my band-to-bypass revision on August 24th (1 more week!). I also had a choice between the bypass and the sleeve. Originally, I was leaning toward the sleeve, but I changed my mind after doing some heavy thinking and research.

I have PCOS, and that, combined with the way I had to eat with the band, has really screwed up my metabolism. I need the malabsorbtion component of the bypass to jumpstart my metabolism, since it's already used to me eating very restricted amounts of food.

The sleeve is just like the band in that it's a restrictive procedure with no malabsorbtion. I've done the restriction-only route already. It worked fine for the first year (once I had some heavy-duty restriction), but eventually your body gets used to it and you have to work really, really hard to keep the weight off and/or continue losing.

One of the most common side effects of the sleeve is GERD. I already have severe GERD whenever I've got restriction from the band, so that leads me to believe that I would likely suffer severe GERD from the sleeve, as well. GERD isn't anything to fool around with. People say, "Oh, it's only some acid." Yeah, well, that acid wears away the enamel of your teeth, it damages your vocal chords, you can aspirate it at night if you aren't really careful (and sometimes even if you are), and it can cause damage that leads to esophageal cancer. It's miserable when it's uncontrollable. With the band, I was eventually sleeping on a high wedge with two other pillows behind me, and still waking up choking at night, and that was WITH the proton pump inhibitor that my first surgeon prescribed AND not eating within at least 5 hours of bedtime.

The sleeve doesn't have that many long-term statistics available as a stand-alone procedure. Sure, it could be hugely successful. I got burned with the band, though. When I had my band surgery, it was being promoted as the next big thing, with projected long-term results that rivaled or exceeded those of the bypass. After a few years, though, the crappy results started pouring in. Sure, I could take a chance that the sleeve is going to be great. But I've had two band surgeries (the original and then a replacement when the original had a massive slip), and I don't want to do this again. The bypass has proven long-term results that are really good, and are still looking like they're 10-15% better than the sleeve. And that can be quite a bit of weight, when you think about it. Plus, there are more and more reports coming in of people having to revise from the sleeve to either the DS or the bypass, so in my view, it's following the same pattern that the band had.

I am like you. I also have PCOS as well as acid reflux and LPRD (laryngopharyngeal reflux disease, which is also called the silent reflux). I haven't had my surgery yet but I know I will be getting the gastric bypass. No other surgery will take care of the acid reflux and LPRD. And because gastric bypass is both restrictive and malabsorption, it will change my metabolism, causing it to be at a higher rate. I don't want something foreign in me. And I only want to have one surgery.

I was banded for 4 years and just actually had it removed due to uncontrollable reflux and vomiting, taking Zantac twice a day (H2 blocker), and Prilosec (proton pump inhibitor) twice a day, avoiding acidic and spicy foods, slept with 8 pillows to avoid aspirating at night, constant heartburn when I ate and when I didn't, was doing damage to my esophagus and not to mention the enamel on my teeth! I just had band removed 2 weeks ago and feel great with NO HEARTBURN for the first time in 4 years! When I spoke to my surgeon, I wanted the sleeve. For many people who haven't been previously banded, the sleeve is a great option, but for banders.....sleeve just makes the heartburn worse due to the high pressure it causes in the stomach. After much research and recommendations and explanations from my surgeon, I have chosen to do bypass. I am scared and worried about potential complications, but what scares me the worst is if I don't do bypass, I will be at higher risk for Diabetes and Heart Disease which runs in my immediate family. My Dad had a heart attack just last year and is dealing with Diabetes, and I am constantly reminding him to drink more Water, exercise more, and be more compliant. As a nurse, I have seen so many complications from Diabetes, (amputations, non healing wounds etc) and that is the scariest of them all. With bypass, that will significantly reduce my risk. Bypass has been around a very very long time and there is tons of info out there. Sleeve is permanent, once your stomach is gone.....its gone forever. Bypass is just re-routing, it can be reversible (not often done because if reversed the risks go back up and a person could get Diabetes again, heart disease, all of those disease processes that come with obesity) I don't want to keep having surgeries. I only need one :) My best advice is to research and keep asking questions until you feel comfortable in your final decision!

The best thing is....., if there is ever a zombie apocalypse, I would have an upper hand with survival compared to many others because I could survive on just a small amount of food! haha! :P Best of luck to you and your decision :)

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