May surgery and surgeon has me second guessing the sleeve

[AntoinetteNY 16]

[mention=313687]antoinette85[/mention]
How much you lose after surgery is basically based on you and how you eat/live. I have lost more weight with the sleeve than most people with RNY. That is because of my lifestyle choices.
I was diabetic. Completely reversed it. The one person I know that had RNY with a family history of diabetes had cured their diabetes with surgery. Then they started eating poorly and regaining, and now they diabetes is making its way back. It is really a roll of dice if RNY will cure you of diabetes or prevent you from every getting it. It isn't a guarantee.
The only reason to choose RNY over Sleeve is if you already have GERD and that GERD is not based on a Hiatal hernia.
In the end you have to live with the choice not the surgeon.
A lot of things that claimed to be guarantees with RNY don't always apply like dumping, most people don't dump long term. People with RNY supposedly lose like 10% more weight, but that 10% isn't really worth having your intestines touched.
JMO

Thank you. I think that may be another reason he offered that. I have had heartburn before and was on omprezole, but I don't suffer from it anymore. I am no longer on the medication. It was after my daughter was born and only after I eat cheese or sauce

[AntoinetteNY 16]

A few questions - how many surgeries has your surgeon done. Did you research him/her as much as the procedures? Have you met with the rest of the team and discussed any of this before today? How long have you been in the process?
If you really feel uncomfortable, then consider changing surgeons, but, when I spoke with my surgeon he asked me the same question. I told him I preferred the sleeve because I was concerned about all the complications with bypass (dumping, etc.). He then laid out the pros and cons in a very thoughtful way and told me his recommendations based upon the 200 bariatric procedures he does every year and has done for the last 19 years.
I trusted his judgment. He has a medical degree. I don't.

Did you switch your surgeries after he laid it out for you? I have met with others on the team. He has completed Many successful surgeries. I am sticking to my decision but now thinking about the Gerd makes me nervous

[AntoinetteNY 16]

I had this experience when I first went in to see surgeon..vice versa. I told my doctor I wanted to do Bypass but when he found out I was a smoker he said he would not perform the surgery . Reason being was because if you smoke when you have bypass you get ulcers. So basically you are in pain all the time. So i decided to do Sleeve. I will tell you that it was the best decision I have ever made. It was non painful except for the gas pain you will have for maybe 2 weeks..I have lost over 60 lbs and I am 4 months post op. I feel better then I ever have. But you have to go with your gut intincts. My doctor was highly recommended and If he told me what was best then I listened to him! Good luck and relax! Everything will be ok!!

R u still smoking? Your surgeon did the surgery knowing you were a smoker?

[AntoinetteNY 16]

My surgeon at first also suggested bypass, mainly because of diabetes and the amount of weight I need to lose (50-60 pounds). She said that I will probably benefit more with bypass but she will perform a sleeve if that is what I want. She told me to keep an open mind when I am doing my research and the biggest deal breaker for me was the dumping syndrome.
I told them I want a sleeve and that is what we are going with.

That's how I feel. Thank you

[PatientEleventyBillion 851]

He's way wrong about reflux.

For the vast majority of people with reflux, even diagnosed GERD like me, only 1 out of 5 cases are worse because of the VSG surgery.

The rest are either diet related or other conditions.

For the majority, the underlying obesity problems causing reflux are more resolved than worsened due to weight loss and dietary improvements and awareness of what foods initiates reflux.

In theory a smaller stomach makes easier reflux but not quite accurate.

I would be skeptical of him trying to push you to RNY. Firstly, the added complications of the surgery makes it a better idea for older people or those like me with comorbidities like advanced liver disease. Risks associated with VSG are much less. Secondly, see if the door is open to revision if you have any issues with the surgery including reflux. My surgeon offered this.

Edited April 9, 2017 by PatientEleventyBillion

[lf1227 129]

Hi all,
My sleeve surgery is scheduled for May 8th. When I met with the surgeon last week to schedule the surgery, the first thing he asked me when he walked in the room was "so why the sleeve?" I answered him and he proceeded to tel me that he thinks bypass would be better for me because on the sleeve, I will most definitely get heartburn for the remainder of my life, also that bc i have a family history of diabetes, that with the sleeve I am more likely in 10 to 15 years to still develop diabetes, and lastly that with my height and weight and getting the sleeve, I will only ly lose about 5 lbs but with the bypass, i will lose around 60 to 80.
I have foe a lot of research and found that the sleeve is the best option for me and I stuck to my guns, even as he stared me down waiting for me to change my mind. But now I second guessing my sleeve decision and thinking the bypass would be better for me.
Anyone have any experience with this dilemma?
Thanks in advance

Hey there! I experienced the same thing! My DR is one of the best, at least in NY and his wife is also a dr that works in the office as well as his son and daughter. My first time there I met with his wife first and explained that I do smoke but would quit, I've been obese all my life, I like sweets but I have no co morbidities and she was set on the sleeve because* I am young (25), relatively healthy, and if I ever took smoking back up it wouldn't be as harmful as with the rny. I was like okay sounds great.
When the actually surgeon met with me he was adamant on the RNY because of my life time obesity, and because of my terrible reflux and because it's the gold standard the only way he would do it is if I quit smoking otherwise he would cancel surgery.
Ya know what I did? I quit smoking and went with the rny and now Im 4 days post op already down 10 lbs!
I was nervous as F about the RNY but all of these surgeries are invasive one way or another and I feel great..plus with the sleeve they pull your excess belly out of your belly button
I just wanted to give you my input because my rny is already treating me well and it's not as scary as my former self and some people think it is.
Best of luck

[OutsideMatchInside 10,166]

I agree with @PatientEleventyBillion I feel like your GERD will probably be resolved with losing weight.

I am also so surprised to read sugeons pushing RNY on people who only need to lose 50-60 pounds, unless you are over 50, that seems like over kill. I have also seen an influx of people lately getting DS, who in the past they would have never pushed it on. If you are young and not slug the sleeve can get the job done. Also being a younger person. I chose the sleeve knowing that if things get out of hand down the line, I have revision options as I get older if I need it (I don't think I will have far exceeded my goals with the sleeve and enjoy my new life enough to protect it at all costs). RNY leaves you no revision options really. I know they tight the pouch for some people or bypass more intestine but its not the same going from like the sleeve to SIPS or DS.

I have lost 182 pounds with a sleeve. You can lose a lot with it if you want to. My Dr is very skilled at them, they are all he does and he sees amazing results.

[PatientEleventyBillion 851]

19 minutes ago, OutsideMatchInside said:

I agree with @PatientEleventyBillion I feel like your GERD will probably be resolved with losing weight.

I am also so surprised to read sugeons pushing RNY on people who only need to lose 50-60 pounds, unless you are over 50, that seems like over kill. I have also seen an influx of people lately getting DS, who in the past they would have never pushed it on. If you are young and not slug the sleeve can get the job done. Also being a younger person. I chose the sleeve knowing that if things get out of hand down the line, I have revision options as I get older if I need it (I don't think I will have far exceeded my goals with the sleeve and enjoy my new life enough to protect it at all costs). RNY leaves you no revision options really. I know they tight the pouch for some people or bypass more intestine but its not the same going from like the sleeve to SIPS or DS.

I have lost 182 pounds with a sleeve. You can lose a lot with it if you want to. My Dr is very skilled at them, they are all he does and he sees amazing results.

Same here. Even though I had big comorbidities along with the crazy weight loss they were under control months ago and significantly improved on the preop diet alone (normalized liver function, massive fibroscan improvements showing likely improved liver diagnosis, hba1c dropping from 7.9 diabetic levels to 5.7 which is normal or pre-diabetic levels). My surgeon has a rep of being a huge RNY fan but because my comorbidities were under control he pointed out the risk wasn't worth it in the mid 30s. Both second opinions saw both surgeons recommend VSG as well. For much of my time in weight management I was pretty set on RNY but reading the research, evaluating risk management, and seeing in person at classes never mind on forums like this the very high positive results combined with lower risk, it turned into a no brainer by the time it came to sign the surgery papers early this year. Unless someone is older or has extremely untreatable diseases with immediate high risk to their lifespan justifying the increased RNY risk, VSG is definitely worth it, in my opinion.

Edited April 10, 2017 by PatientEleventyBillion

[AntoinetteNY 16]

My surgeon at first also suggested bypass, mainly because of diabetes and the amount of weight I need to lose (50-60 pounds). She said that I will probably benefit more with bypass but she will perform a sleeve if that is what I want. She told me to keep an open mind when I am doing my research and the biggest deal breaker for me was the dumping syndrome.
I told them I want a sleeve and that is what we are going with.

Yea, the dumping syndrome was my deal breaker too

[AntoinetteNY 16]

He's way wrong about reflux.
For the vast majority of people with reflux, even diagnosed GERD like me, only 1 out of 5 cases are worse because of the VSG surgery.
The rest are either diet related or other conditions.
For the majority, the underlying obesity problems causing reflux are more resolved than worsened due to weight loss and dietary improvements and awareness of what foods initiates reflux.
In theory a smaller stomach makes easier reflux but not quite accurate.
I would be skeptical of him trying to push you to RNY. Firstly, the added complications of the surgery makes it a better idea for older people or those like me with comorbidities like advanced liver disease. Risks associated with VSG are much less. Secondly, see if the door is open to revision if you have any issues with the surgery including reflux. My surgeon offered this.

Thank you, I will look I to that.

[AntoinetteNY 16]

I agree with [mention=309438]PatientEleventyBillion[/mention] I feel like your GERD will probably be resolved with losing weight.
I am also so surprised to read sugeons pushing RNY on people who only need to lose 50-60 pounds, unless you are over 50, that seems like over kill. I have also seen an influx of people lately getting DS, who in the past they would have never pushed it on. If you are young and not slug the sleeve can get the job done. Also being a younger person. I chose the sleeve knowing that if things get out of hand down the line, I have revision options as I get older if I need it (I don't think I will have far exceeded my goals with the sleeve and enjoy my new life enough to protect it at all costs). RNY leaves you no revision options really. I know they tight the pouch for some people or bypass more intestine but its not the same going from like the sleeve to SIPS or DS.
I have lost 182 pounds with a sleeve. You can lose a lot with it if you want to. My Dr is very skilled at them, they are all he does and he sees amazing results.

That's great to hear, thank you

[AntoinetteNY 16]

Same here. Even though I had big comorbidities along with the crazy weight loss they were under control months ago and significantly improved on the preop diet alone (normalized liver function, massive fibroscan improvements showing likely improved liver diagnosis, hba1c dropping from 7.9 diabetic levels to 5.7 which is normal or pre-diabetic levels). My surgeon has a rep of being a huge RNY fan but because my comorbidities were under control he pointed out the risk wasn't worth it in the mid 30s. Both second opinions saw both surgeons recommend VSG as well. For much of my time in weight management I was pretty set on RNY but reading the research, evaluating risk management, and seeing in person at classes never mind on forums like this the very high positive results combined with lower risk, it turned into a no brainer by the time it came to sign the surgery papers early this year. Unless someone is older or has extremely untreatable diseases with immediate high risk to their lifespan justifying the increased RNY risk, VSG is definitely worth it, in my opinion.

Thank you. U appreciate it

[AntoinetteNY 16]

Thank you. I appreciate it

[Diana_in_Philly 1,426]

19 hours ago, antoinette85 said:

Did you switch your surgeries after he laid it out for you? I have met with others on the team. He has completed Many successful surgeries. I am sticking to my decision but now thinking about the Gerd makes me nervous

I had a sleeve on 8/23/16. I have already lost 69% of my excess weight and I'm almost 8 months out. I have lost 84 pounds at this point and still losing. I never had issues with reflux that I knew before surgery, but have chosen to stay on Protonix as when I stopped it about 3 months after surgery I did have some issues. However, the risks to the drug are minimal so I have decided to continue with it for a year and then re-evaluate. My doc said he'd do either - that it was essentially my choice - but has proclaimed me a 'rock star' - his words with my progress. However, I am extremely committed to this with a very specific goal - my oldest daughter graduates high school in June and I want her to be proud of the family photos and not ashamed because her mother looks like a beached manatee. My BMI has gone from 48 to 33, a size 22 (barely closing) pants to sagging size 12s and a few size 10s. This was the best decision I ever made. Unlike many on the boards - I'm not young. I'm 55 with bad knees but now I fence (as in en garde) 2x a week, do pilates and work out with a personal trainer and love all of it.

[GoddessMoon 108]

Regardless of which you choose to go with you will still lose weight, that part is up to you. I was stuck on the gastric bypass up until 2 weeks ago when I met with my Surgeon. He said it was the best option for me and it is the more popular one he performs nowadays. I would recommend you stick to your guns on this one and possibly get another surgeon.