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I chose sleeve. My primary reasons were no rerouting of my intestines, I didn't have a history or acid reflux, and arthritis does run in my family, so keeping NSAIDs as an option was attractive. (Your doc may say differently about NSAIDs and the sleeve, but mine permits them when used judiciously). Plus being able to eat almost anything after healing seemed like a good idea to me.

Some mention dumping as a reason to get bypass. You won't know until you have surgery whether you will dump or not. Plus some sleevers, myself included, have dumping. Dumping can also go away after several months or years.

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I chose bypass because I need to lose approx 50% of my current, starting weight (my BMI is 49), and I know that I (personally) need every possible advantage to help me reach my goal. I am also 49 years old, my metabolism will be slowing down soon, and I don't feel like I have much more time to waste. I have been overweight since toddlerhood, and I am ready for this to be done.

I am quite healthy now considering my BMI, no co-morbidities except sleep apnea, so I am comfortable that I will be able to heal well. And I am having my surgery at Duke, so I have huge faith in the skills of my surgical team.

I have GERD now, don't want to take the chance that it will get worse if I had a sleeve, and hate the thought of a revision surgery if my GERD got dangerous.

So, it's RNY for me on Thursday, barely 3 days to go!

Going to support groups for a few months pre-op and talking with people who have had both surgeries really helped me with my decision.

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Good luck gina171.... I am excited for you!

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I'm like Djmohr, I never dump and I'm able to tolerate everything I could want, though that doesn't mean I actually eat whatever I want. It's entirely possible to have bypass without dumping, especially if you follow the plan to a t from the beginning. It gets a lot less restrictive further out. Just adding to the perspective! :)

Cervidae brings up some great points.

As an aside, sometimes on-plan foods can trigger dumping. Refried Beans are a go-to purée for many people. They sent me running to the potty. Try foods individually to make sure they work with your new stomach. If something doesn't work out the first time, wait several weeks and give it another try. Unfortunately, the reverse is also true. Sometimes you can develop an intolerance (or distaste) for a food that used to work for you. I had this with yogurt

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Rely on your surgeon's opinion...they know which is best for your set of circumstances. I started my journey thinking the sleeve was right for me, but because of high blood pressure, diabetes, and kidney problems caused by pain meds, my surgeon thought bypass was the way to go. Be open-minded enough to consider what your surgeon suggests...he/she is the expert in this situation. Good luck!

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Edited by LibraryLadyDW

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@@okiegirl1980

My surgeon chose for me. He chose the sleeve, as he was concerned that I may have medication absorption issues with bypass. I have to take Thyroid med for life, and this med is very sensitive to any changes.

So I followed my surgeon's recommendation as he is the Expert.

I had some reflux issues initially and dumped 3-4 times in the past 5 months, mainly on dryer, fatty, heavy food.

I have lost a nice chunk of weight, and still keep losing.

Sleeve is working for me.

Good luck and let us know what you and your surgeon decide to do.

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Thank you all! These answers totally help. Did you all start working out prior to surgery? Already active or not at all?

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I thought I wanted the bypass but my surgeon highly suggested the sleeve. I was 58 with high blood pressure as only health issue. I wasn't totally convinced I could lose all the excess weight with the sleeve but surgeon was. He also said if I have issues with bypass there is no other surgery, but the sleeve can be converted to bypass down the road if necessary.

I am very pleased at 2 mths out and feel like I am leading a normal. I am semi active and did not formally exercise before surgery. I am now though.

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I thought I wanted the bypass but my surgeon highly suggested the sleeve. I was 58 with high blood pressure as only health issue. I wasn't totally convinced I could lose all the excess weight with the sleeve but surgeon was. He also said if I have issues with bypass there is no other surgery, but the sleeve can be converted to bypass down the road if necessary.

I am very pleased at 2 mths out and feel like I am leading a normal. I am semi active and did not formally exercise before surgery. I am now though.

I was the opposite. I wanted the sleeve, but my surgeon recommended the bypass.

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@@okiegirl1980 - I was actually leaning toward the lapband initially. It seemed like a good "starter" way of seeing if this worked for me. I ended up rejecting it because of need for follow up with the surgeon (who was in Mexico) and revisions and slippage.

I was not interested in getting my bowls worked on (the idea of dumping just scared me, since I teach so much). But I warmed up to the idea of the Sleeve when I read about the Cleveland Clinic research where they were following patients for four years. The need for follow up care was low compared to the other procedures. So, it seemed like the most bang for the buck, and cheaper on the back end.

All of the procedures are tools. You still must do the work. If you do, it will change your life. Much tougher as a woman than a man. You are 36, which means you will start getting new attention from guys, which will alter your relationships. If you have not dealt with your food issues, you will be at risk of switching from food to alcohol (or something else). But if you work this on the nutritional/spiritual/emotional levels in a couple of years you will eventually find a new normal, if you are serious.

I hope you really appreciate the many thoughtful responses here. I was scanning through the comments, and they were first rate and very fair descriptions of the ups and downs of the procedures. My last bit of unsolicited advice is to Google "WLS fails." There are many videos and blogs of those who didn't do well on this (statistically 20% or so). Look at them carefully. I found most of them failed because they thought this was a magic wand. WRONG. It's still work. But it can change your life in very good and profound ways if you are committed. I have done things I have not done in decades and I am still enjoying the ride.

I wish you and my fellow Oklahoman's the best of luck on this. Always feel free to reach out if you have a question.

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@@OKCPirate Thank you thank you! I do appreciate all of the responses. I hope I didn't come across as though I don't. They were all sincere and gave wonderful perspective.

I am very sure and educated about Wls. I do understand the risks associated and the fact that people can channel their food issues into other compulsive activities. I must admit I am ready and willing to face any challenges head on. I have a great support system and am willing to reach out if I need help.

I want the ride that I deserve. I have missed out on some pretty badass things Bc of hang ups and inability to keep up.

I will continue to do research and hopefully will come up w the best plan for me. Cheers Mate!

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If you have reflux bypass is best & that's recommended from Vanderbilt University Weightloss & I have no regrets 3 yrs post op

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@@gina171 Hi, may I ask which doctor is performing your surgery? I too go to Duke metabolic clinic, and am seeing Dr Yu. Im actually waiting on my insurance approval, they just submitted last week. My BMI is also 49.59. My surgery is revision though, I had my Lap Band (placed 2007) removed 3 weeks ago, and am revising to RNY. When Dr Yu took my band out 3 weeks ago he discovered it had punctured a hole in my diaphram, so we are thinking insurance approval is likley. Maybe we could be buddies :)

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@@gina171 Hi, may I ask which doctor is performing your surgery? I too go to Duke metabolic clinic, and am seeing Dr Yu. Im actually waiting on my insurance approval, they just submitted last week. My BMI is also 49.59. My surgery is revision though, I had my Lap Band (placed 2007) removed 3 weeks ago, and am revising to RNY. When Dr Yu took my band out 3 weeks ago he discovered it had punctured a hole in my diaphram, so we are thinking insurance approval is likley. Maybe we could be buddies :)

Hey there! I also had Dr. Yoo, and he was terrific. I also thought that their new fellows are pretty terrific too. I worked several times w Dr. Alvarez (a fellow) and he was great with a perfect bedside manner. I can't say enough good things about the program, and my care at the hospital from check in to being wheelchair-ed out.

Do you have a pre-op and surgery date yet? I will be at the next Support Group Meeting in September, decided to pass on tonight bc I'm only 5 days post-op.

I am really, really pleased with my decision to have the bypass, and Dr. Yoo definitely helped me get there.

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If you have reflux bypass is best & that's recommended from Vanderbilt University Weightloss & I have no regrets 3 yrs post op

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I had GERD before sleeve surgery. I took Nexium for 4 months post op. I am now 18 months post op and have not had one episode of GERD since surgery. My surgeon wasn't worried about my GERD. I was mild but enough that I was on Nexium prior to the surgery and still would occasionally have an episode of reflux.

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Nexium worked for me too! Nothing else worked but Nexium. Took it for over 4 months, now I am slowly weaning myself off it. So far so good. Reflux seems to be gone :)

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