Major Question...Pre-Op...Feeling really lost and indecisive.

[Eshadowgirl 1]

My story: I am 38, my HW was 365, and im currently 346.8

My goal is to be at 190.

I want the Gastric sleeve.

I have a surgery date of April 6th.

My endoscopy showed a Small hiatal hernia. The surgeon said at first that can be fixed.

Later he says it wont be, because its not big enough and im not symptomatic.

Then he states, instead of the Gastric Sleeve that I want.......He feels the RNY would be more beneficial, and I would be more successful with it. He states with my high BMI and "impaired fasting glucose" I would do better with RNY

The downside is its $2000 for RNY than the Sleeve.

The financial aspect is where Im really struggling. Ive maxed out my options for financing. I have a Care Credit card for $8K

I have a $4,000 cap with insurance that will pay part of the hospital portion. I still have to fork over $3350 to the hospital.

Ive also always been comfortable with my decision to go the Sleeve route. Its no rerouting, they take 80% of my stomach...No worries bout malabsorbtion or anything. I have no reflux issues.

I am pre diabetic(a1c of 6.0) and my glucose levels have been normal since July of last year.

I am active being I workout regularly, I watch my eating habits, and have modified them quite a bit. My blood pressure is hereditary and well controlled. I have hormone imbalance(pcos).

So Friday I go in to the Doctor to discuss all this. My pre op apt is 3/25, liquid diet to start a week before surgery.

Am I going to fail with the Sleeve? Should I Just give up, because trying to get $2000 isn't going to work. We just don't have it in our budget. We are barely squeaking by if I get this sleeve.

Can the surgeon also refuse surgery if I don't go with the RNY??

Im lost...Any advise would be great.

Thank you.

[JamieLogical 8,684]

I don't think you will "fail" with the sleeve Both surgeries have similar long-term outcomes. They are both simply tools and it is up to you how to use that tool to your best advantage. It sounds like your surgeon has some legitimate reasons for suggesting RNY over sleeve, but it is 100% YOUR decision. If you want the sleeve and feel it is your best option, financially and in terms of what you want for your future, then out your foot down and tell him so. Just make sure that you are *hearing* what he is saying and making an informed decision for yourself.

As for your high BMI, there are people who weigh over 500 pounds who are successful with the sleeve. You likely won't lose weight as quickly with the sleeve, but that's not necessarily a bad thing unless your weight is posing an imminent threat to your health. Yes, the malabsorption of RNY allows you to lose weight more quickly. But that malabsorption is there forever. Even once you've lost all your excess weight. So you will always have to be compensating for it in your nutrition for the rest of your life.

[MarciaN 391]

I don't know what your BMI is but I started at 52. I am now down to 34- have lost a little over 100 pounds with 49 left to go. As JamieLogical said above- these are tools. If you are committed to using the tool and following your doctor's program you won't fail. It is all up to you. (Oh-- I forgot to mention that I had the sleeve.)

[rking 484]

i agree. it is YOUR decision. You can lose the weight with the sleeve.

i agree. it is YOUR decision. You can lose the weight with the sleeve.

i agree. it is YOUR decision. You can lose the weight with the sleeve.

i agree. it is YOUR decision. You can lose the weight with the sleeve.

[rking 484]

i agree. it is YOUR decision. You can lose the weight with the sleeve.

[CowgirlJane 14,259]

I switched surgeons.

Mine told me I would fail with the sleeve because I had done poorly with the lapband....different surgeon, 4 years later and the sleeve has proven to be a great choice for me. My BMI was also 52 (pretty high) and I am maintaining a normal size/weight now.

However, RNY is proven to be more effective at reducing diabetes so I can see his point/bias, but clearly losing weight has many life saving benefits.

[rking 484]

Just for the record, I was diagnosed as diabetic in June last year, with an A1C of 6.7. No, it is not horribly high, but still diabetic. My surgery was Nov. 2015 and in January 2016 I did bloodwork and my A1C reduced to 5.7, which is no longer considered diabetic, but pre diabetic. I had the sleeve. I was super pumped!

[liposuction68 178]

sleeve !!

[katanne 215]

If RNY is not in your budget, it's not in your budget. That's your reality, period. Our circumstances are what they are going into this. As others have said, the sleeve is also a good surgery. I see your surgeon's point re: a greater chance of reducing diabetes, but MANY here have seen good resolution of diabetes with the sleeve also. If you use your tool correctly, you'll see results regardless of which type of surgery you get. He probably will not refuse to operate if you stick with the sleeve. If for some reason he does, you can switch to a different surgeon.

[BeachAngel 3]

After many years of research, plus I work in the medical field and had opportunities to discuss the RNY with several physicians, I decided against the RNY procedure due to the long term complications that can occur. About 8 months ago I learned of the gastric sleeve procedure. After researching it, I felt completely confident this was the procedure for me. I had my surgery Nov 17, 2015. I am down 56 pounds and counting. I am 100% happy with my decision. I, like many others, feel I will reach my goal weight and be happy. If you do not feel comfortable with the RNY, don't do it! This is a life altering surgery. My surgeon totally supported my decision on the sleeve procedure. I know it's not easy to be this far into the process to change your mind but, it is your life, your health and ultimately your decision. Do not settle, get a second opinion

[Eshadowgirl 1]

Thank you all for your advice/comments and stuff. Its a lot to take in....

I am comfortable with the Sleeve, both mentally, emotionally...and financially.

Today I meet with my surgeon...I know he wants me to have RNY.....So we shall see how this plays out

Thanks again everyone!!

[JamieLogical 8,684]

@@Eshadowgirl Definitely post back here and let us know how it goes with your surgeon today.

[rking 484]

@@BeachAngel my surgery was on nov 17th too!!!!! looks like you are doing great!! yesterday was our 4 month surgiversary! I am about 45 lbs down. sooooo glad i chose the sleeve. i was going to have lapband and changed my mind.

[OutsideMatchInside 10,166]

I had similar starting stats age and weight. I had been diabetic controlled with diet and pills for several years.

I'm 8 months now, and I don't take any diabetes meds, and my blood sugars are normal. I still test them now and then, fasting and shortly after eating to just to make sure it is really true and they are normal to the low end of normal all the time. I'm noteven at goal or close, I am only down a little over 100lbs.

My Dr only does the sleeve. He said I was young and active and there was no reason I needed RNY. You can lose and lose quickly with the sleeve.

Long term it doesn't matter if you get the sleeve or RNY. Once you are healed you can eat around either surgery if you choose to, and people regrain and/or never meet goal with both. Check both forums. RNY is not magic.

If you don't want RNY and you can't afford it, don't have it. Since you are paying cash, you can switch Doctors if you want. I wasn't comfortable with having my intestines touched, I would have opted not to have surgery rather than have that option, it is just not something I want at all. If you feel like that, go with your feeling. You have to live in this body, not the Dr.

Edited March 18, 2016 by OutsideMatchInside

[Pea523 28]

I have been a diabetic for over 15 years. I was on insulin before I had surgery. I am now only on 500 mg of Metformin daily with and a low carb diet. I can not take more than that because it upsets my stomach. My fasting levels hover around 106-127 in the morning. It used to be 160-190 with two types of insulin! I had my surgery on the same day as @rking. I believe we're also around the same weight. She has lost a bit more than I have, I am down 40 and my BMI was around 37.

As she said, her A1C has gone to normal and she is very fortunate. I am not sure how long she has had it. Maybe she can chime in on this.

My whole point of this is that while I am still a diabetic, I am still a doing a lot better than I was. Studies show that people who have had diabetes for under 5 years can expect to see a complete resolution of their diabetes with the sleeve when on a low carb diet. Even with my being diagnosed almost 16 years ago, I am still doing well. I still have 35 more lbs to go and my levels are getting better every day! I have read other studies that show that it can take a year for people to see a complete resolution in their diabetes. I think this is because there is a strong correlation between visceral fat, which is fat around the organs, and diabetes. The more fat you have in your liver and pancreas, the more likely you will experience symptoms. I would like to have a MRI to see if my liver and pancreas are still fatty.

So if you decide to go with the sleeve, and your blood sugar does not go to normal immediately, don't worry it will.

With your diagnosis being so new, I would just go ahead with the sleeve. As someone else posted, the RNY is a more committed procedure, and it requires much commitment on your part, and there are more complications along with it.

Hope this helps!