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Readytobeme

A Few Questions

22 posts in this topic

I have a few questions that I am hoping someone here will be able to answer. I am rethinking getting sleeved and now starting to think that bypass may be the better way to go for me. Here are my questions.

1. Has anyone ever had to have revision from RNY to sleeve?

2. I have read many posts/blogs about people getting revision from sleeve to RNY. What I don't understand is in some cases it is done for being malnourished. Since the sleeve can't be reversed and the person being revised no longer has 90% of their stomach, what would be bypassed? Would this not increase the lack of absorbed nourishment since bypass creates lack of absorption? 

3. This is one that I have thought about for awhile. It is known that when people get older they lack the ability to absorb many nutrients. Has there been any studies done on how either surgery affects the elderly later in life?

 

The more that I read and learn, the more that I am talking myself into going with the RNY. :)

Thanks in advance for your response to my questions.

 

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For what it's worth, I would have gone with a sleeve if I had been a candidate for it; I just felt like it would be less invasive, less change, and I see so many people here with sleeves who've done just as well as those with RNY.  I wasn't a candidate for sleeve, though - I had Barrett's esophagus and reflux.  Those are basically dealbreakers for the sleeve.  I'm perfectly happy with my RNY so far, though!  

Re: #3, my surgeon said it was not an issue (I asked this question myself).  He said when someone reached an age where they needed nutrition in ways besides orally, the method of introducing it to the system would be essentially the same.  He also said my chances of reaching an age where I needed to worry about it were a lot better if I had surgery, so I went with it.  

(My other question was "what if there's an apocalypse and I don't have access to vitamins" and his answer was basically "first make sure you can outrun the zombies; worry about vitamins after.")

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For what it's worth, I'm 5 years out (almost), just had lab work and all my labs were good.  Even my iron which I'm usually low in.  That said; I religiously take my supplements.  Not taking them is not an option.  My bone density scan last year was great.  

 

Edited by Cheesehead
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Thanks for the replies! I know that I am obsessively overthinking it all but, this is a huge life change. I so want to get it right the first time around.

I will be taking vitamins and supplements religiously as well. I do that now after obsessively researching and overthinking which ones to take. :lol:

When I had my initial appointment the other day, the nurse told me not to have my mind set on either one until after I meet the surgeon. I won't be able to meet the surgeon until I complete 5 support classes. I just want to be as informed as possible before I do meet with them. You guys are all great. Thank you so much for the information and support.

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1. Not possible (according to my surgeon).

2. Sleeve would be made smaller & small intestine would be rearranged. Possible malnutrition with sleeve could be attributed to acid.

3. I haven't read studies on this but fear of it (bypassers excluded from certain bone treatments, etc.) played into why I got the sleeve. Another big reason: I can't live without NSAIDs. And another: I wanted the unused stomach OUT. I don't need a perpetually empty stomach sending signals to my brain. I think a lot of my weight problem is hormonal, and the benefits of the sleeve in this area really sold me.

Do what's right for you. I think you'll be successful whatever you choose.

Edited by Gretta
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Thank you, Gretta. I sure hope so. Failure is just so ingrained in me that I really fear choosing the wrong one.

I do understand that either one is what you make of it though.

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2 minutes ago, Readytobeme said:

 

I do understand that either one is what you make of it though.

So true! I know you'll make the most of the tool you receive because you really care.

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With the help and support of the good people on this forum, I will do well. I am determined to! :)

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I have two more questions that I think someone here will be able to answer.

1. I think that I read somewhere that we have to be very careful post op not to pull too much air into our new pouch? If this is the case use of my cpap worries me a little. I feel sure that the pressure from it will force air into my stomach. Should I be concerned?

2. What about the titanium staples during an MRI? Have they been problematic for anyone here?

Thanks is advance for taking the time to read and answer.

 

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I've had a couple of MRIs since my original stapling without any problem. Mind you they were on my foot, not my stomach. I declared they were there and never had any questions asked or issues raised by the tech. Titanium has a very weak magnetic field. My mother was given MRIs on her two titanium knee joints by her surgeon without issue. That said my followup on my foot surgery which now has titanium screws is by CT Scan, not sure if the metal is the reason though or if a CT is just standard practice for what has to be checked. My ortho practise does have an in house MRI if needed.

CPAP isn't an issue. Air in the intestine can be uncomfortable.....and noisy, but it won't burst your staples these days. With any luck you won't be using the CPAP  once you get some decent weightloss happening.

Edited by Aussie H
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Titanium is considered "MRI compatible". It's very weakly magnetic & shouldn't cause a problem.

Plenty of WLS patients use CPAPs with no trouble.

Edited by Gretta
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14 hours ago, Readytobeme said:

I have two more questions that I think someone here will be able to answer.

1. I think that I read somewhere that we have to be very careful post op not to pull too much air into our new pouch? If this is the case use of my cpap worries me a little. I feel sure that the pressure from it will force air into my stomach. Should I be concerned?

2. What about the titanium staples during an MRI? Have they been problematic for anyone here?

Thanks is advance for taking the time to read and answer.

 

I'm five months out and have been using a CPAP for about 16 months. 

About three months after surgery I had one episode of burping towards the morning (none before or since). I mentioned it at my pulmonologist appointment a few weeks later, and she reduced the pressure from 8.4 to 7.6, I believe. No problems since, and my AHI is fine.

I'm supposed to email her when I get close to goal weight, to get a new sleep test. 

Edited by Carina
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Wow @Carina your pressure was pretty low from the start compared to mine. My cpap was actually converted to a bipap but, my pressure is set at 22 right now. I am sooooooo looking forward to being able to stop using it altogether.

Thanks for the replies.

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31 minutes ago, Readytobeme said:

Wow @Carina your pressure was pretty low from the start compared to mine. My cpap was actually converted to a bipap but, my pressure is set at 22 right now. I am sooooooo looking forward to being able to stop using it altogether.

Thanks for the replies.

I may not be able to stop, since my AHI was 91 when I had my first sleep test, so my apnea was very serious. :o But I'll cross that bridge when I come to it. ETA: I never had any real problems with the CPAP; it just took one or two nights to get used to. But sleeping "naked" is nicer, of course.

Edited by Carina

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Just now, Carina said:

I may not be able to stop, since my AHI was 91 when I had my first sleep test, so my apnea was very serious. :o But I'll cross that bridge when I come to it.

 I may be in the same boat as you are. Mine is also severe. Plus I was overweight when diagnosed but not morbidly obese.

I have been using the cpap for so long that it lulls me to sleep. May have a hard time sleeping without it at this point anyway.

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I have another question. The info that I was given for my surgery says that I will be tested for H Pylori. I was able to find out what it is through Google. It seems that there are several ways to test for it though.

How do most WLS docs test for H Pylori?  Hoping that they do it at the same time they do upper endoscopy?

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1 hour ago, Readytobeme said:

I have another question. The info that I was given for my surgery says that I will be tested for H Pylori. I was able to find out what it is through Google. It seems that there are several ways to test for it though.

How do most WLS docs test for H Pylori?  Hoping that they do it at the same time they do upper endoscopy?

Because I had the sleeve, they sent the removed portion of my stomach off to pathology to test for that. Good info to know since you have to take more precautions to prevent ulcers if you have it. Not sure how testing goes for RNY.

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8 hours ago, Readytobeme said:

I have another question. The info that I was given for my surgery says that I will be tested for H Pylori. I was able to find out what it is through Google. It seems that there are several ways to test for it though.

How do most WLS docs test for H Pylori?  Hoping that they do it at the same time they do upper endoscopy?

I was tested for H Pylori a couple of years ago. In my case it was a simple blood draw.

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Thank you both for the replies. That is good info to have. I was hoping that they didn't wait until right before surgery to test and treat if needed. I was thinking that would be just my luck that I would test positive and have to delay surgery yet another 2 weeks.

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13 hours ago, Readytobeme said:

I have another question. The info that I was given for my surgery says that I will be tested for H Pylori. I was able to find out what it is through Google. It seems that there are several ways to test for it though.

How do most WLS docs test for H Pylori?  Hoping that they do it at the same time they do upper endoscopy?

There is a test called a urea breath test - you drink a liquid with urea and if you have H pylori there is more of an indicator gas made. There is also a stool antigen test where they look to see if there are any H pylori bacterial parts using a fecal sample. Lastly if you have endoscopy they can do a biopsy and look under the microscope for the bacteria. 

The blood test looks for antibodies to H pylori, but it could be positive because you had it in the past, and not now, so the above are better. 

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7 hours ago, BurgundyBoy said:

 

The blood test looks for antibodies to H pylori, but it could be positive because you had it in the past, and not now, so the above are better. 

It may well give a false positive, but that can be further tested if a positive result happens. If it's a negative result (as mine was) then no further need for what to me seem nastier testing protocols.

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I do know that I will have endoscopy so hopefully that is when they will test me. Thanks for the replies.

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