Hi everyone,

I am scheduled for VSG on December 26th. Last week I went to do my upper GI with contrast. The nasty barium swallow. Well apparently in my report they found some abnormalities of my esophagus and some reflux. My surgeon said in my report that usually the liquid just goes down, but with me it shot up almost to my clavicles and then back down. I don’t notice this at all while I’m eating or drinking.

As a result my doctor wants me to do an endoscopy and a motility test to check the function of my esophagus and how I swallow. He said depending on the results he could switch me to the bypass. I really do not want to do the bypass due to malabsorption, dumping syndrome, and cost because I am self pay. I have been waiting to get VSG for years and I’m afraid this test will come back abnormal as well. Has anyone had these tests done and still gotten the VSG even with abnormalities? What is the motility test like? Any information would be helpful.

my surgeon will fix the upper Gi issue during the course of the VSG.. He had told me that from the beginning, that if he saw anything that would cause reflux or anything he would fix it.. Maybe i am misunderstanding the issue and one has nothing to do with the other.. but i would check into them fixing it while in there doing the surgery.

A couple of things - I am a bypass person by the way.

You say you don’t want the bypass due to cost (that is reasonable! I was mostly self-fund and it is tough - but worth every cent)), the malabsorption and dumping.

Malabsorption and dumping are really a much smaller deal than people seem to imply. Re the malabsorption, I take a 10c vitamin pill every day and a 15c folic acid tablet. That really isn’t a big deal! And the dumping? Well, I had it initially, and it was a real help for me to change how I eat. I don’t know what your eating habits are like, but I was obese because I ate way way way too many sweets, as comfort or habit. A couple of episodes of dumping early on made even the thought of sweets very unappealing - so I stuck absolutely to my programme and got to goal weight in 6 months. The dumping has passed and I wish it hadn’t - not it is just willpower and I know that isn’t my strong suit!!

I am only telling you things because I would encourage you to do the thing that is best for your health. Those “problems” with a bypass are really small in the scheme of things. And there are a lot of people end up having a revision from VSG to bypass - often reflux related.

So maybe try and be a bit open to the idea of a different surgery even if it is your second choice? A bypass will help you get thinner (on average) quicker (on average) and any side effects you have are entirely manageable - and reflux will be dealt with, so you’ll no longer be quietly damaging your insides.

For some reason and I'm not sure what it is there is a perception out there that a sleeve is an easy or minor surgery compared to a bypass.

Let's think about that. With a VSG your surgeon takes a large portion of your stomach cuts it off and throws it away.

With an RNY your surgeon rearranges the way your stomach is connected but doesn't throw anything away.

So they are both MAJOR surgeries.

A VSG is a restrictive only procedure. An RNY is both restrictive and malabsorptive. For me after having had one procedure that only gave " restriction" I am quite happy to consider a procedure that gives both. I don't see taking daily multivitamins as an issue.

There is a high risk of reflux with a VSG.

Dumping - it's not something I'm looking forward to but it may just be what I need. If eating chocolate or sugary foods causes me to feel like crap then I am a lot more likely to not eat them. Not all bypass patients get dumping but for the ones that do it may be just the thing that they need to help them stay on track.

So my advice would be LISTEN TO YOUR SURGEON. If he advises 1 procedure over the other keep an open mind and ask lots of questions as to why he thinks it would be better. If you are willing to trust him with your life then you need to be able to trust his judgement .

On 11/21/2018 at 17:39, elcee said:

For some reason and I'm not sure what it is there is a perception out there that a sleeve is an easy or minor surgery compared to a bypass.

Let's think about that. With a VSG your surgeon takes a large portion of your stomach cuts it off and throws it away.

With an RNY your surgeon rearranges the way your stomach is connected but doesn't throw anything away.

So they are both MAJOR surgeries.

A VSG is a restrictive only procedure. An RNY is both restrictive and malabsorptive. For me after having had one procedure that only gave " restriction" I am quite happy to consider a procedure that gives both. I don't see taking daily Multivitamins as an issue.

There is a high risk of reflux with a VSG.

Dumping - it's not something I'm looking forward to but it may just be what I need. If eating chocolate or sugary foods causes me to feel like crap then I am a lot more likely to not eat them. Not all bypass patients get dumping but for the ones that do it may be just the thing that they need to help them stay on track.

So my advice would be LISTEN TO YOUR SURGEON. If he advises 1 procedure over the other keep an open mind and ask lots of questions as to why he thinks it would be better. If you are willing to trust him with your life then you need to be able to trust his judgement .

I completely understand that both procedures have their own risks and neither is better than the other. Again my last comment was that bypass is more expensive and I probably won’t be able to afford the bypass if that’s the only route he can take. He said he’s not 100% certain yet and VSG definitely still is on the table, but I’m just trying to figure all of it out along with the stress that I may not even be able to get a surgery if we can’t do the VSG due to cost. Obviously malabsorption is still an added factor to consider and it was just one of my reasons for choosing VSG. I completely understand that my doctor will only do what’s best for me because neither of us want to see me suffer after surgery if VSG will cause major issues. We will see.

I understand cost is an issue, I hate the fact that I now have to fork out for an RNY when I paid for a band years ago. For that reason I would want to be sure that the surgery I was choosing was the 1 that was right for me. I wouldn't want to do the cheaper surgery as a second choice to save money as in the long run it may end up costing more.

What is the price difference? If the surgeon recommends that you go with a procedure other than the VSG would it be possible that you could fund the difference if you waited a couple of months? It might be better to wait rather than run the risk that you have major reflux issues and the need for further surgery in the future.

Good luck with the tests . Let us know how you go