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Why did you decide to do sleeve instead of RNY?



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I just met with my surgeon and she basically gave me the option of Bypass or Sleeve. She said she would recommend me for either surgery, but she would lean more towards sleeve because I am young and hopefully have a good 60 years ahead of me and that's a long time to be maintaining a pouch...like there are more risks and a long time of taking crazy amounts of Vitamins, etc. I was initially leaning more towards bypass because I am not doing WLS as a method to lose weight, I am doing it as a tool to keep the weight off. And I wanted dumping syndrome to keep me in line because high fat sugary foods are my slippery slope. I do have faith in myself and I am confident that I can do this if I really set my mind to it, with or without dumping syndrome, but I wanted that extra assurance. But I do agree with her, the sleeve is less risky and invasive and that's comforting. What made your decision?

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I chose sleeve over RNY for many reasons:

  • No rerouting of my digestive system
  • The idea of my old stomach still being inside me, where it might develop ulcers or cancer down the road and be harder to diagnose/treat since an endoscopy could no longer reach it concerned me
  • I couldn't really understand what the loss of a functioning pyloric valve might mean for me. Like, does my stomach pouch still send signals to my brain for it to open and close, and it's just over there with my old stomach randomly opening and closing? Weird!
  • Also, since my pyloric valve would no longer be holding food in my pouch, wouldn't everything just pass right through into my intestines? What if it didn't have enough time to sit in my stomach juices and get broken down enough for my intestines to handle?
  • I liked the idea of eventually being able to eat whatever I want, just in moderation. I didn't want to give up all the foods I loved forever. In reality though, post-sleeve I don't really want a lot of those foods anyway. Still, at the time I was going through the process of surgery, it was reassuring to me to know I would eventually be able to eat those foods again.
  • I was concerned about the malabsorbative aspect of RNY and the potential for developing deficiencies.
  • I was self-pay and sleeve is much cheaper!

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I second most of what Jamie listed. I was given the same choice and my doctor said the same thing, he'd recommend me for either.

At my age (29), he said I should do fine with either one. I went with the sleeve because it seems slightly less extreme as a first step, and the sleeve can be revised into a bypass down the line if necessary.

I'm 2 weeks post op today and feeling pretty great. Good luck to you either way!

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I always think of it as the "drastic bypass". But I did think that if the surgeon recommended it, I would accept that. When I met with him he said he thought the sleeve was the best option for me, and would really only recommend the bypass for me if I had really bad diabetes.

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I forgot to list my starting BMI as one of the reasons I chose sleeve. When I began pursuing WLS, my BMI was right at 40. Bypass is usually recommended for people with higher BMIs than that or other comorbidities (I didn't have any).

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I didn't like the malabsorption of the bypass.

The whole dumping syndrome scared me. I ride horses including trail riding for hours at a time. I just can imagine needing to GO NOW and being in the woods somewhere dragging a horse behind me. It is one thing for a quick pee behind a bush but no just no for anything else.

I pay medical claims for a living. At one point I was paying only catastrophic claims. About 12 years ago my first claim that I paid that hit $1 million dollars was a RNY that went wrong. The staples popped and leaked while still inpatient. I read the case management notes, it was not pretty. I had another that was $500,000+. I do understand that complications can occur with any surgery but these stuck out for me since they were particularly high dollar for the time.

I also was talking to a case manager nurse and she told me about a bypass patient she had when she was a home health nurse. She had to pack the opening and could get her arm into the patient almost up to her elbow. That pretty much did it for me.

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I was aiming for a 100 pound loss, (no more) and didn't need the added component of malabsorption and the side affects\risks that come with re-routing.

I did not have diabetes.

I had mild reflux that my doc believed could be "fixed" with hernia repair done with the sleeve procedure. (R\Y is typically offered as the only option if your reflux is bad).

I wanted to avoid dumping syndrome, (I wasn't COMPLETELY successful in that as my sleeve WILL dump if I binge on sugar. Small amounts or the occasional treat is fine).

Turned out to be a good choice! Health problems including chronic reflux all gone and off all meds to control them within 6 months!

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