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Interested in sleeve but dr suggests mini bypass



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I was steered from the sleeve to the mini bypass by my dr. After meeting with a nutritionist this week and saw what all I will be doing daily with Vitamins, minerals, supplements, shakes, B12 shots, etc, along with the complicated lists of veggies and other foods I can’t eat, I’m turned off with the mini bypass. Is it just as complicated with the sleeve and are there future medical issues that are different than with the mini bypass?

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You do have to take Vitamins, supplements, and a B complex for the rest of your life on the sleeve, too, and you start with liquids (surgeons vary, some require Clear Liquids before you get thicker liquids), then on to purées and soft foods, and my surgeon recommends avoiding things like cruciferous vegetables (e.g., cabbage, broccoli, cauliflower, kale, Brussels sprouts...) until you are fully healed and know your own reactions.

I don't think there's any such thing as a bariatric procedure with a simple post-op.

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Generally, the sleeve will be less fussy than the malabsorbing procedures when it comes to supplement requirements, however, they will all have some initial requirements for the first few weeks or months as you need some additional nutrition since you won't be eating much for a while. shakes are a part of it, for a variable amount of time, as that's the only way other than real food to get our needed Protein. Over time, there will be little that you can't eat with a sleeve -which is good and bad. Good in that you can, in principle, be able to get all of your nutrition from food if you are so inclined (most aren't, which is why they still need to supplement some.) Bad in that you can still eat junk that goes against your weight maintenance goals. Some people need supplements, even with no WLS at all, simply because that is how their body works.

Some programs impose the same supplement regimen on their sleeve patients as they do for their bypass patients, not out of necessity for the sleeve but for their own (the practice's) convenience. Periodic lab checks will tell you what you personally need to stay healthy.

Are you having your WLS done here in the States, or in MX? The mini bypass is rarely done here in the US and is rarely covered by insurance and AFAIK has not been endorsed by the ASMBS as an approved, mainstream procedure. I would do some further research as to why this is before proceeding. The mini is done in MX, primarily as a cheaper alternative to the RNY, and is also more commonly done in some other countries. Here in the States, I would shy away from it for the same reason that I wouldn't own a French car (irrespective whatever merits they may have) as they haven't been sold here for decades and finding parts and service is a PITA. Likewise, should you have problems with a mini sometime down the road, finding someone who knows how to treat it can be a problem; if you have a sleeve or RNY, any bariatric practice at any hospital will know what you have and how to treat it.

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I’m having it done here in Atlanta by a highly experienced and respected bariatric surgeon. He has done many of them and likes them because with only the one hook up, there is less chance of future issues or leaking. Does the same as regular bypass…

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Actually you only need to continue with Vitamin supplements with a sleeve if you personally need to i.e. blood work show you’re low in specific Vitamins, etc. The sleeve only changes your tummy not other parts of your digestive system. The additional changes that occur with a bypass does increase the impact on your ability to absorb the necessary nutrients.

I had sleeve surgery & haven’t taken a vitamin since month 8 when I was in maintenance. But digestive systems can work differently cause we have different physiologies so you may need to take vitamin supplements regardless of the surgery you have.

Generally the post surgical diets for sleeve & bypass are pretty similar. The staged return to eating (liquids, then purées, then soft food & finally more solid foods) is to support your sensitive & healing digestive system. There also are certain foods you introduce more slowly into your diet because they’re just too harsh to begin. Both surgeries tend to focus on high protein, low carbs, low fat, low sugar, nutrient dense foods. This is a lifetime thing if you want to maintain your weight loss. In time you can eat most foods just depends on how your body tolerates them but this generally is an individual thing.

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I see people saying that you have to be on supplements for the rest of your life with the sleeve, this isn't necessarily the case. It depends on the person and that is why it is strongly encouraged you do an absorption panel each year. What I did was stay on my supplements for two years as my body adjusted, come to find out, I was actually overdosing on Vitamins.

That being said, your diet greatly influences the type and amount of nutritional vitamins you get. Again, another reason why absorption panel is necessary each year.

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you'll likely have to take Vitamins with the sleeve, too - maybe not as many because it doesn't have the malabsorption piece, but the sleevers I know in person all take them. I see people above saying not necessarily - that it depends on the person and their lab results. They would know more than I would since I didn't have that surgery, although I think the majority of sleevers do take daily supplements.

I didn't have any food restrictions once I got a ways out from surgery. I couldn't eat those things you mentioned when I was early out, but eventually, I was allowed to add those things back to my diet (although I had a regular bypass - not a mini bypass. Not sure if it would be different with a mini or not. I would think not - but then, I'm not familiar with that surgery)

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@Jerald180 :

truth is you won’t know how you will fare after either surgery until you have the surgery.

you can read about all the possibilities or probabilities of outcomes, but u will never know if you will be part of the percentages that don't fall in the posted statistical range.

I had the sleeve, prior to surgery I understood that dumping was on the rare side for sleevers. Surprise! I dump. It may be rare, but I got it anyway (though the effects have lessened over the years)

re: vitamins: like @Arabesque, i stopped taking my Vitamins long ago (i think around the 1 year mark). All my labs have been satisfactory since (i’ve had about 5 since stopping). Im relatively fit and have tonnes of energy.

In my insignificant opinion, you will be served well by either, so long as you work your plan. So go with what YOU are comfortable doing with a surgeon who supports it.

P.S. My surgeon let me choose (between sleeve and RNY). I didn't have GERD, and he said he was comfortable doing either and that it was my body and i had to live with it, so i should decide what gets done to it.

Edited by ms.sss

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Some sleevers need Vitamins long-term and some don't. I'm one of those that do, in fact I had a B12 scare recently. Somehow my B12 got low and I got the whole list of nasty symptoms (minus pale skin, for obvious reasons, LOL):

Weakness, tiredness, or lightheadedness
Heart palpitations and shortness of breath
Pale skin
A smooth, sore tongue
constipation, diarrhea, loss of appetite, or gas
Nerve problems like numbness or tingling, muscle weakness, and problems walking
Vision loss
Mental problems like depression, memory loss, or behavioral changes

What caused me to know something was seriously wrong was the "problems walking" part. I fell three times in 10 days and it hit me that's not normal.

I had to increase the dose of B12 I am taking and I'm still not free from all the symptoms, although I'm better. So it's a roll of the dice - you could be off supplemental vitamins relatively early or you could need them longer.

Edited by Jaelzion

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