I'm so unsure of what I want! Help!

[jtellechea001 87]

Hi Everyone!

So I've been in this process since June, gotten all my blood work done for the sleeve, had my psych evaluation, met the surgeon, had my one nutrition visit and up to now I was so sure I wanted the sleeve! I'm an RN, and I'm doing my surgery in my hospital system just another hospital! I happen to speak to the Bariatric Coordinator at my hospital and she told me DO THE BYPASS! If you're going to have he surgery done, get it done right the first time! She was explaining to me that she's seen the results with the sleeve and they're not as great as the bypass! She also mentioned that the long term results are much better with the bypass! So me as a nurse, I'm taking everything she said into consideration but now I'm stuck and I don't know what to do! My BMI is 46 and and I don't have any comorbities. I explained to her that I'm terrified of dumping syndrome. She also went on to tell me that having dumping syndrome is GOOD because it will remind you to not eat that food again and it will keep you from being in a hospital!

Has anyone else gone through this last minute? Was it an issue for insurance purposes? Did you have to change your surgery date? My surgery date is scheduled for October 6!

Please any insight will help!

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[Inner Surfer Girl 12,015]

Personally, I would talk to your surgeon about what is right for YOU.

[KristenLe 5,980]

Please don't change your mind based on one person's opinion. I don't think dumping syndrome is a good thing - but that's just me. Talk to your surgeon and decide what's best for you. You can be as successful with the sleeve as bypass. Both are just tools - you need to do the work.

[LipstickLady 25,682]

I'd have to disagree that the sleeve results are not as good at the bypass and I am seriously not sure why some people keep insisting on spreading that idea.

That said, only YOU can decide what you are more comfortable with. I was MUCH more comfy with the idea of losing due to restriction rather than malabsorbtion. (Is that spelled right?) I know I am horrible at taking Vitamins. I wasn't diabetic, I like my intestines and the idea of the sleeve taking out a good portion of the grehlin production zone was attractive to me. I also hated the idea of dumping, but ironically, I still do with the sleeve. Them's the breaks, I guess.

Make your list of pros and cons and do what YOU want to do. Good luck!

[jtellechea001 87]

Well it's an educated opinion. She's been the bariatric coordinator for over 15 years at my hospital so she's seen it! I just don't want to regret my decision later

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[OutsideMatchInside 10,166]

@@jtellechea001

The sleeve and the bypass are the same long term. At the 2 year mark the results are almost exactly the same. Bypass patients will lose faster in the very beginning but those stop losing faster.

The person that gave you the advice doesn't seem to be that knowledgable about bypass, because most bypass patients don't dump and those that do, only usually dump early on. I have an associate that had bypass 4 years and they eat incredible amounts of sugar (and have regained about 1/3 of their loss and they never hit goal or anything close to it, never got under 200), and they do not dump or get sick.

Finally if in 10-20 years you need some kind of revison, with the sleeve, at least you can go to the DS. If someone wastes their bypass and regains all or most of their weight back, they are stuck with that "gold standard" and no where to go.

In 1 year I exceed my 2 years expected weight loss with the sleeve and probably in the next 6-12 months I will probably get to or below my desired goal weight.

The tool doesn't matter, what matters is the person using it.

Also if they are having results that bad with the sleeve at that hospital, then they aren't doing them right. a well formed sleeve is just as good if not better than bypass. The skill of the surgeon matters in the Sleeve.

Edited September 5, 2016 by OutsideMatchInside

[ShelterDog64 2,364]

@@jtellechea001 I was sure the sleeve was the right procedure for me, then I started wavering right before my final appointment with my surgeon. I was having some of the same thoughts as you about weight loss, and I was concerned that I wouldn't get the same result from a sleeve that I would with a RnY bypass.

My surgeon and I talked for almost an hour, and it turned out (for all the reason I already knew but had started doubting) the sleeve was the right surgery for me. I'm in my early 50s and have a long history of moderate to severe iron-deficiency anemia. At my age/history, I didn't think I needed to introduce malabsorbtion into my life. My BMI wasn't crazy high and I wasn't diabetic. I've always been able to lose weight, just haven't been able to maintain. All of these factors had convinced me that the sleeve was the way to go, and despite a lot of noise from friends who've had bypasses, the sleeve was absolutely the way to go.

My best advice is talk to your surgeon about your thoughts and concerns. My opinion, at only 10 weeks out, is that a huge portion of success with WLS is your dedication to using the tool you have appropriately, whether it's the sleeve or the bypass. We'll see where I am at one year, and I may be fooling myself, but I think I made the right decision. Good luck and can't wait to hear how it goes for you

[gina171 626]

I was driving myself insane with the same question earlier this summer. My BMI was 50, I am 49 years old. Bypass seemed so much more extreme to me, so much to heal, I was afraid I wouldn't heal right inside (My mother never healed correctly from a cancer surgery years ago and I was terrified that I would fare the same....). What swayed me were the 5 year weight loss numbers for for RNY and VSG that my program has has seen, and they were very different. Not close. The 2 year numbers were practically the same, but not the 5 year numbers. And my program is seriously solid, with lots of pre-op and post-op follow up, high numbers of people coming back for follow ups whether they're successful or not.

Then I realized my mother had been highly non-compliant with her nutrition and Water intake after surgery, i.e.: would refuse food completely every other day and then would drink maybe 16 oz of Water a day. And stayed in bed all day, unless she needed the rest room. For months at a time. Once I realized I would never do that, I was less afraid of healing.

My RNY recovery has been smooth, and I feel like I have given myself the best possible chance of achieving my goal of serious weight loss and health. But....I am super motivated and maybe I would have been as happy with the sleeve.

I feel I made the right decision for me.

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Edited September 5, 2016 by gina171

[Inner Surfer Girl 12,015]

Well it's an educated opinion. She's been the bariatric coordinator for over 15 years at my hospital so she's seen it! I just don't want to regret my decision later

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I am sure she is very experienced. But, keep in mind, she probably only sees folks with issues/complications more than those that don't. The bypass was much more common 15 years ago, too. So her numbers may be scewed.

[tholbert08 51]

If you look at the differences between the two procedures, yes the bypass is the gold standard but if it was the best, why did the sleeve evolve? There are good reasons for both options. Educate yourself then talk to your doctor to help with their opinion. Me, personally, I choose the sleeve over the bypass as, if there are any issues long term, i.e. the hiatal hernia correction isn't effective, I can have the bypass as a plan b. There is no plan b with the bypass.

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[LipstickLady 25,682]

Well it's an educated opinion. She's been the bariatric coordinator for over 15 years at my hospital so she's seen it! I just don't want to regret my decision later

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My initial surgeon was with a center of bariatric excellence, had a very high number of successful bypasses, a low number of complications, etc. He had 20+ years of bariatric experience and he insisted bypass was the only way I'd lose weight.

I switched surgeons to one who supported my request for a sleeve. My initial surgeon was dead wrong despite his professional opinion.

[gina171 626]

If you look at the differences between the two procedures, yes the bypass is the gold standard but if it was the best, why did the sleeve evolve?

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The sleeve evolved the same way new drugs and surgical protocols evolve.....because surgeons and researchers are constantly looking for new ways to serve people and change health outcomes....just as they should! They're not complacent and are driven to pursue new ideas in the hopes of helping more people. And I'm glad they do just that! (and I had RNY!)

Just look at all the people here who didn't want the RNY for their own reasons, but who were happy to get the sleeve and as a result, hVe changed their lives! Thank God for the surgical pioneers who developed the sleeve, they've saved countless lives.

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Edited September 6, 2016 by gina171

[ocgirl15 667]

There are pre WLS patients for which RNY is the best choice whether it is their starting BMI, severe diabetes or GERD. Others like me with a starting BMI of 42 and no recognized co morbidities. Sleeve was best and RNY would be overkill. Then there is the rest of the WLS patients... Which is probably most of us. Either will get the job done if you are compliant. You can also seriously fail with either. I think if someones fail at bypass they would have failed at sleeve and vice versa. In other words it really doesn't matter. Discuss with your surgeon and if they don't have a clear opinion based on your specific conditions then do what feels right.

[jtellechea001 87]

My understanding, anyone with a BMI of 40 and above is a surgical candidate for RNY. I just want to make sure I make the right choice for myself and follow my heart in what will be best for me.

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[LipstickLady 25,682]

Anyone with a BMI of 40 and above is a surgical candidate for the sleeve, too. Most insurance companies use 40 as the base minimum for any WLS if there are no co-morbidities.