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Have to make a decision about RNY right NOW, panicking!



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I am looking for guidance. I sort of have a gun to my head right now to have my RNY gastric bypass before the end of the year due to insurance reasons, but I am still not absolutely sure I want to have the surgery. Some of it is fear, but some of it is also the fact that I feel like I haven't tried hard enough to lose it naturally.

So, I currently have BCBSM, and after Jan 1 I will be switched to United Healthcare due to an acquisition of my company. I was told by more surgeon that it is highly unlikely that I will get approved by UHC if I wait to have the surgery, but BCBSM will definitely cover it and I have already met all my deductibles for the year. Today I set a surgery date for 12/18/17 out of sheer panic, and all I have to do before surgery is get an EKG and a signature from my PCP.

My dilemma is this: I am a 5'6" female, age 30, currently weighting 228 lbs. I have a BMI of 37, starting weight was 255 (BMI 41) at the beginning of my mandatory 6 month diet. During month 4, I saw an endocrinologist and was diagnosed with Hashimoto's thyroiditis and polycystic ovary syndrome (PCOS). She put me on Metformin and Synthroid, and I immediately felt like I had more energy and the weight started coming off way quicker than before. I feel less hungry, less depressed, and better able to make healthy choices. I am wondering if I can just follow a healthier diet on my own now that my thyroid isn't ruining everything! I talked to my surgeon today and he told me that the chances of me succeeding in losing more than 50 lbs without surgery was about 3%. My weight loss with the Metformin and Synthroid is starting to plateau now, but I am not sure if it is just because I have been making bad eating choices since Thanksgiving or if it is because my body is now used to the medicine and I will go back to struggling to lose weight even when eating sensibly. My PCP is against me having the surgery and thinks I just need to put my mind to it, but he is a skinny dude and not an expert in the field. My endocrinologist thinks the hormone changes from RNY would help with my Hashimoto's and PCOS, so she is for it. My surgeon says I am obviously not going to die without surgery because my BMI is not super high, but he doesn't think based on my genetics/family history/comorbidities that I will be able to get below 200 lbs on my own. He says he has done surgeries on women like me and they were very happy with their decision.

If you were in my shoes, what would you do? Is a RNY too much of a nuclear option for me? I can't do the sleeve because of my history of reflux and ulcers, so I am torn.

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I am in your shoes, but older, and I am having surgery in March. You really don't want to carry this extra weight for decades more -- it impacts your joints, heart, and breathing. The statistics for losing and maintaining without surgery are pretty pitiful. I'm going with a sleeve, but I keep wondering if the sleeve will become the band of the future -- as in, requiring retrofits.

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Hi Wesja - In the end, it's your call. You know yourself better than anyone else and only you can weigh risks vs. benefits. However, as someone with the EXACT medical conditions -- Hashimoto's and PCOS -- I need to tell you that having gastric sleeve surgery has been nothing short of miraculous for me. It has completely reset my metabolism and allowed me to do the impossible -- lose weight. A lot of it. Six months in and I've lost 64 pounds. Something that was impossible for me before surgery. And, I've had zero complications and zero side effects.

I'm a lot older than you, and I wish this option was available to me many years ago. The older I got, the more these metabolic conditions kept me from longterm weight loss success. When I added a physical disability and menopause into the mix -- gah! I was roadkill. Oh and by the way -- my endocrinologist and primary care doc both said I didn't need the surgery. That I wasn't "fat enough." Now, they're both thrilled with my weight loss and improvement to my overall health.

I wish you the best of luck. If you have questions for me, shoot me a message. Take care!

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It is a tough decision. My primary reason why I had RNY gastric bypass surgery was because my obesity finally reached a point that it drove my health into the tank. I had high blood pressure and diabetes and prescription meds were losing their effectiveness. Also I slid into a number of other health issues like GERD, sleep apnea to name a few. Generally I had reached my date code and my life was on a downward spiral. Within a couple weeks after surgery almost all my health conditions went into remission and remained there. I am 4 1/2 years post op. It even corrected another health issue, asthma. But this was a much slower process, taking a couple years. Now I am off all my prescription meds. All of them. So I am very pleased with the results and would do it again in a heartbeat.

Most individuals who try dieting to lose weight suffer the yo-yo effect. They lose weight, it is good for awhile but then they go off their diet and the weight comes back on and then some. Every diet equals another 10 or 20 pound increase.

I am not familiar with your conditions (Hashimoto's thyroiditis and polycystic ovary syndrome (PCOS)). But I have heard these conditions discussed on this website before. So you might search the internet for a discussion or perhaps someone with these conditions can chirp in.

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You have to make the decision that is the best for you. I, however, would have the surgery. The hurdles are cleared, and the deductibles are met. I wish I could have had surgery at 30. That would have given me 15 more years of bliss. This was the absolute best decision that I have ever made for myself. I struggled with my decision as well. I was at 326 two months before surgery, and 289 on my surgery date. That amount of weight loss weighed on me. However, I remembered all of the diets that I had endured during my lifetime...How I had lost and then regained a bit more than I started with. I just can't say enough about the value of having good health, and not having to worry about my weight every waking hour of my life.

Good luck with your decision!

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10 hours ago, James Marusek said:

It is a tough decision. My primary reason why I had RNY gastric bypass surgery was because my obesity finally reached a point that it drove my health into the tank. I had high blood pressure and diabetes and prescription meds were losing their effectiveness. Also I slid into a number of other health issues like GERD, sleep apnea to name a few. Generally I had reached my date code and my life was on a downward spiral. Within a couple weeks after surgery almost all my health conditions went into remission and remained there. I am 4 1/2 years post op. It even corrected another health issue, asthma. But this was a much slower process, taking a couple years. Now I am off all my prescription meds. All of them. So I am very pleased with the results and would do it again in a heartbeat.

Most individuals who try dieting to lose weight suffer the yo-yo effect. They lose weight, it is good for awhile but then they go off their diet and the weight comes back on and then some. Every diet equals another 10 or 20 pound increase.

I am not familiar with your conditions (Hashimoto's thyroiditis and polycystic ovary syndrome (PCOS)). But I have heard these conditions discussed on this website before. So you might search the internet for a discussion or perhaps someone with these conditions can chirp in.

I agree with this- I would say really consider whether you are scared or whether you really think you can/want to do it on your own. I, too have had a health spiral down as my weight has gone up progressively after every diet. I have Hashimotos and suffered endometriosis and a myriad of other things that affected my weight. You can feel good when first on thyroid meds but if it's like my thyroid it's up, down and all over the place and you are constantly battling exhaustion and weight gain.

So if it were me, I'd probably lean towards doing it because I have lived the years since one of my besties did it - watching her get and stay healthy and me slowly getting bigger and more unhealthy. I wish I'd done it then.

That said, if you don't do it I fully support that.

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On the Hashimotos front, I was diagnosed as a freshman in college weighing a grand 120-130 #s -- which I maintained until marriage. Hashimotos *wreaked* me -- Hair loss, exhaustion, Constipation. But I never lost weight when I started Synthroid. Now, 30 years, 2 kids, menopause -- there's little hope of fixing this nonsurgically.

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On the Hashimotos front, I was diagnosed as a freshman in college weighing a grand 120-130 #s -- which I maintained until marriage. Hashimotos *wreaked* me -- hair loss, exhaustion, Constipation. But I never lost weight when I started Synthroid. Now, 30 years, 2 kids, menopause -- there's little hope of fixing this nonsurgically.

That’s me exactly! I had to have a hysterectomy at 29, so that jumped in the mix.


Surgery Date : TBD in Jan 2018
Status: final appts and insurance approval

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Thanks for all of your thoughts and advice everyone. I am going to move forward with surgery. My official date now is 12/20/2017, and I feel relieved now that I have committed to a decision. Starting to get excited too!

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Thanks for all of your thoughts and advice everyone. I am going to move forward with surgery. My official date now is 12/20/2017, and I feel relieved now that I have committed to a decision. Starting to get excited too!


I think you’ll really be happy. And we’re all here going through it with you! Congrats!


Surgery Date : TBD in Jan 2018
Status: final appts and insurance approval

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You Go GIrl!!! Congrats and good luck. You'll do great.

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On 12/6/2017 at 8:27 AM, wesja said:

I am looking for guidance. I sort of have a gun to my head right now to have my RNY gastric bypass before the end of the year due to insurance reasons, but I am still not absolutely sure I want to have the surgery. Some of it is fear, but some of it is also the fact that I feel like I haven't tried hard enough to lose it naturally.

So, I currently have BCBSM, and after Jan 1 I will be switched to United Healthcare due to an acquisition of my company. I was told by more surgeon that it is highly unlikely that I will get approved by UHC if I wait to have the surgery, but BCBSM will definitely cover it and I have already met all my deductibles for the year. Today I set a surgery date for 12/18/17 out of sheer panic, and all I have to do before surgery is get an EKG and a signature from my PCP.

If you were in my shoes, what would you do? Is a RNY too much of a nuclear option for me? I can't do the sleeve because of my history of reflux and ulcers, so I am torn.

get the surgery! 1,000 times over. for 2 reasons:

1 - if you’re struggling this much with weight (and health and thyroid) when you’re this young, do you think things will get better/easier as you get older? i just turned 40 and let me tell you, it does not. all your issues will continue to worsen, including your weight after a few more yo-yo’s. get the surgery because it works and you’ll be able to go on with your life without struggling with your weight. you’ll never need synthroid or metformin again either.

2 - i know it might seem like a “nuclear option” (your words), but it’s really not. you have a problem (as do we all), and this is a fix. it’s as simple as that. but the main thing is how normal life is after surgery. YES, you will be able to eat and enjoy food still. NO, if your surgeon is good, you will not experience complications.

again, i wish i could go back to when i was 25 or 30 to do this surgery. would have saved a lot of energy, heartache, and health damage. i’m happy to read you’ve decided to go ahead.

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I have my bypass surgery on Dec 18th. Super nervous, but so ready to start this new chapter. I had a good conversation with @JohnnyCakes and I will tell you that after talking to him and others successes on these forums, i felt sure that I was making the right choice. I'm happy for you. You made the right choice. See you on the other side of this weight loss success journey.

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1 hour ago, JohnnyCakes said:

get the surgery! 1,000 times over. for 2 reasons:

1 - if you’re struggling this much with weight (and health and thyroid) when you’re this young, do you think things will get better/easier as you get older? i just turned 40 and let me tell you, it does not. all your issues will continue to worsen, including your weight after a few more yo-yo’s. get the surgery because it works and you’ll be able to go on with your life without struggling with your weight. you’ll never need synthroid or metformin again either.

Untrue that OP will never need Synthroid again if she loses the weight. That is not a legitimate claim you can make about WLS, that it will resolve autoimmune hypothyroidism.

Hashimoto’s is an autoimmune disorder in which antibodies directed against the thyroid gland lead to chronic inflammation. This means she’ll almost certainly need to be on medication the rest of her life. What changes with weight loss is the dosage she’ll require.

I have this disorder and as I’ve been losing weight post gastric bypass I’ve had to have labs drawn every few months and my medication adjusted a couple of times. I’m currently below goal weight and am at the low end of normal BMI. My endocrinologist is very happy with my weight and T3 & T4 levels.

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3 minutes ago, MarinaGirl said:

Untrue that OP will never need Synthroid again if she loses the weight. That is not a legitimate claim you can make about WLS, that it will resolve autoimmune hypothyroidism.

Hashimoto’s is an autoimmune disorder in which antibodies directed against the thyroid gland lead to chronic inflammation. This means she’ll almost certainly need to be on medication the rest of her life. What changes with weight loss is the dosage she’ll require.

I have this disorder and as I’ve been losing weight post gastric bypass I’ve had to have labs drawn every few months and my medication adjusted a couple of times. I’m currently below goal weight and am at the low end of normal BMI. My endocrinologist is very happy with my weight and T3 & T4 levels.

you are correct. i must have glanced over the Hashimoto’s part. my bad.

that said, the surgery usually does correct subclinical hypothyroidism. it did with me. it also lowers inflammation in general, so i’d be curious to see how it affects Hashimoto’s. sounds like you got on top of yours. congrats!

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