Hi there,

I just started my bariatric journey and am awaiting my one-on-one appointment with my surgeon.

My basic healthy history is High Blood Pressure, NAFLD, PCOS, Sleep Apnea, Anxiety/Depression. I had my gallbladder removed 5 years ago, just had my colonoscopy and was just diagnosed with Type II Diabetes (A1C was 7.8).

The 2 options for surgery are either gastric sleeve or RNY. According to all the charts, etc., looks like RNY may be best but of course it's more invasive. My surgeon only does RNYs laparoscopically, not open.

Not sure what the final outcome will be but...would like anyone's 2 cents about which surgery they chose if they have a similar medical profile.

I just changed my diet - and rather drastically - because of the diabetes. As low carb as possible, lots of water, veggies, etc.

I'm hoping to bring my weight down as much as I can before surgery and then of course, there's the liquid diet yet to come....

My largest concerns are my liver - I've been taking Organic Milk Thistle for quite a while, not sure it helped much according to recent bloodwork - guessing my diet is what's going to help? I've also had a liver biopsy when I had the gallbladder removal. Second concern is getting that A1C down. Diabetes came as a surprise as my A1C had been in the 5 range for the longest time. Of course, I gained weight over COVID...and have been stressed, you name it. Going through perimenopause, etc.

Any advice, I'm all ears! Thanks!

Do you have GERD? GERD is the biggest risk for sleeve - sometimes it gets worse after sleeve, and sometimes people who never had GERD develop it. There are more complications with RNY, but it's still pretty safe. If you take a lot of meds for your anxiety and depression, your doctor and surgeon may recommend sleeve to ensure you can absorb these medications properly; this is what my surgeon said and my psychopharmacologist agreed, although I got a second opinion with a different surgeon, and she didn't think an RNY would be a problem with the meds, but she still recommended sleeve because it's an easier surgery and she feels the weight loss is just as good.

I has wanted RNY in the beginning, but with both surgeons pushing for sleeve, and the risks of higher complications with RNY, I chose to go with sleeve. I hope I don't end up with GERD (I had it for a while but it resolved with better eating).

Hi ready for new me…I am also new to this forum. My surgeon has set my date of November 9th. I will have one week clear liquid diet before surgery. I have chronic gerd so I am having the gastric bypass. I have been jumping thru hoops since March 2021 so glad to have a date set. Covid is really bad here so dates may shift..but I am glad to just be in the rotation.

10 minutes ago, Oakgrovelady said:

Hi ready for new me…I am also new to this forum. My surgeon has set my date of November 9th. I will have one week clear liquid diet before surgery. I have chronic gerd so I am having the gastric bypass. I have been jumping thru hoops since March 2021 so glad to have a date set. Covid is really bad here so dates may shift..but I am glad to just be in the rotation.

I hope your date doesn't get pushed too far out by COVID. It's not as bad here in Boston, but I'm still worried it might cancel my surgery.

When I told my dr that I thought I wanted bypass he asked me if I had gerd and if I was a big sugar eater. I guess either of those things would justify the higher risks (which are still VERY low). The answer to both of those questions is no. I decided because absorption issues were less with sleeve that I would have less issues to work through with my bipolar meds and probably need less extra vitamins in the long run plus it had the lower risk so I went with it.

Thanks so much for the responses. I do not have GERD, fortunately. These things are good to know. The surgeon did mention that Sleeve was the most popular among the bariatric surgeries he performs. My OBGYN said the same thing about COVID - hope it doesn't push back bariatric surgeries.

re: open vs laproscopic RNY - almost all RNY's are done laproscopically these days. Although I suppose there's a rare situation where one has to be done laproscopically, the only people I know who had open ones had them done many years ago.

I went with RNY primarily because I had GERD. Also, when I had my surgery a few years ago, the sleeve was just becoming popular - it was rapidly replacing the lapband as the RNY alternative. I had a fear of it turning into "Lapband 2" a few years down the road, so I wanted the tried & true. RNY had been around for awhile and it had a lot of solid research behind it. However, VSG has been around long enough at this point that I wouldn't have that particular concern if I was making the decision today, but I would still go with the RNY because of my GERD issue.

I'm still very happy with my decision. There are more potential complications with the RNY, but honestly, both surgeries are very safe, and major complications are rare.

15 hours ago, catwoman7 said:

re: open vs laproscopic RNY - almost all RNY's are done laproscopically these days. Although I suppose there's a rare situation where one has to be done laproscopically, the only people I know who had open ones had them done many years ago.

I went with RNY primarily because I had GERD. Also, when I had my surgery a few years ago, the sleeve was just becoming popular - it was rapidly replacing the lapband as the RNY alternative. I had a fear of it turning into "Lapband 2" a few years down the road, so I wanted the tried & true. RNY had been around for awhile and it had a lot of solid research behind it. However, VSG has been around long enough at this point that I wouldn't have that particular concern if I was making the decision today, but I would still go with the RNY because of my GERD issue.

I'm still very happy with my decision. There are more potential complications with the RNY, but honestly, both surgeries are very safe, and major complications are rare.

Thank you for sharing, I'm so happy to hear about your great experience. Glad to hear that either surgery will be great.

RNY is still the gold standard for WLS, especially if one is diabetic, pre-diabetic, have GERD or reflux, or are super-sized. It is the more complicated surgery, but also has the best results, and it does not involve removing most of one's stomach. Some surgeons do only VSG, or prefer to do VSG because it's easier. I'm glad you found one who does RNY.

I originally thought that I would have Gastric Bypass, but after meeting with the doctor and discussing it with him, we thought that the sleeve was a better choice for me as it was less invasive.

Like you, I had high blood pressure, PCOS, and already had my gallbladder out years ago. I was pre-diabetic.

I did not get heartburn/acid reflux and that was one of the criteria that would have made him suggest RNY instead. I think that he also looks at diabetes & A1C levels to help determine which surgery to recommend.

It may be helpful to discuss your options again with your doctor after all your testing comes back & after you continue your research on both surgeries. Asking people on here about their surgeries is a great way to hear about personal experiences.

I wish you success with whichever surgery you choose! Lots of luck!??

Removing most of one’s stomach is hardly “less invasive”. I’m surprised that your surgeon didn’t tell you that RNY gastric bypass usually resolves pre-diabetes and Type 2 diabetes. RNY is still the gold standard of WLS.

4 hours ago, Sunnyway said:

Removing most of one’s stomach is hardly “less invasive”. I’m surprised that your surgeon didn’t tell you that RNY gastric bypass usually resolves pre-diabetes and Type 2 diabetes. RNY is still the gold standard of WLS.

When he said less invasive, he meant that it didn't alter as many organs. They are both surgery and invasive. I was not opposed to RNY and realize it may be "the gold standard", but it is not the only option. My pre-diabetes was borderline and my A1C was under 6 before surgery, so he believed the sleeve would resolve it also. This is what he suggested for ME. I also have been anemic in the past, so the absorption of nutrients was possibly another reason he suggested VSG. We did seriously consider both, so I am aware of the benefits of RNY as well.

Edited September 5, 20215 yr by Candace76
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