Belia1227

RNY vs sleeve

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Hello I am new here and would like some advice regarding RNY. I am all done with prerequisites and thinking bout the sleeve. I do have lots of weight to lose. I was wondering why your chose RNY over sleeve. Starting weight 420 current weight 366. It has been hard these last 6 months. I want lasting results and be healthy.  TIA

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I didn't have a choice, but if I did I would have opted for RNY. The longevity of the procedure was enough for me, but add in the additional malabsorption factor and for me would be a no brainer. If I was going to have surgery then I wanted the gold standard procedure.

I had a very significant reflux issue which is what made my surgery medically necessary. I doubt there would have been a surgeon in the world that would have recommended the VSG in my case. There are lots of threads here on this subject so while waiting for replies it's worthwhile doing a search of the forum.

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Thank you I will look at them.

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The decision on whether to have the sleeve or a gastric bypass is a really important one, and you should be sure to pick the surgery that best fits what you want.  You will live with the effects of this choice for the rest of your life.

In some ways it is simple - both the vertical sleeve and RNY gastric bypass have their own advantages and disadvantages.  Each of them can help you lose weight and get to your goal weight, and then maintain at your goal weight.  As an informed consumer you need to make the weight loss surgery choice that is best for you and your needs. Note that sometimes this choice is mandated by your health insurance company or by your choice of surgeon (not in my case - BCBS of MA let me chose my surgery type, and my surgeon had lots of experience with both procedures).  Also, some people should only have one of these surgeries due to other medical conditions.

I chose gastric bypass for the following reasons (and have never regretted this choice);

1.  Gastric bypass surgery has a higher success rate than the vertical sleeve.  Quite frankly, if I am going to have weight loss surgery, then I want the most effective surgery.

2.  Gastric bypass has been performed for much longer than the vertical sleeve - so the side effects for gastric bypass are better known.

3.  Gastric bypass combines two separate weight loss methods into one surgery (small stomach pouch and malabsorption of calories), while the vertical sleeve has just one (small stomach pouch).  To me, more is better.

4.  Nothing is taken out of your body with the gastric bypass surgery, so that it can (in theory) be reversed - this is not true for the vertical sleeve.  More importantly, with gastric bypass (unlike with the vertical sleeve) you retain the rest of your stomach (besides your small pouch) in your body, so that in case of an ulcer or some other problem with your small pouch many years from now (which is not unusual) you will have spare and healthy stomach tissue inside you for a surgeon to use to make a new pouch.

5.  The people that I knew who had the gastric bypass lost all the weight that they needed to lose and got to their goal weight - while many of the people that I know that had the sleeve did not make it to their goal weight.

6.  The risk of GERD (gastric reflux) with gastric bypass is very minimal, while GERD is a common side effect of the vertical sleeve.  

7.  The major downsides of gastric bypass - having to take vitamins the rest of my life, a longer surgical procedure, and facing the possibility of dumping - were acceptable risks to me.  Taking vitamins is no big deal (and since I buy them at CVS on sale, it is not a major expense), since I was knocked out for my surgery I did not care that it took longer to perform the surgery, and I only dump about once every six months (any only after I do something "stupid" like eating a big bowl of ice cream).

I fully respect people who get the vertical sleeve, but I love my life with gastric bypass).  I eat an amazingly normal and healthy diet now that I am at my goal weight, and am able to lose any sudden weight gain (such as after a vacation) with ease.

Be sure that if you choice gastric bypass that your surgeon performs this surgery a lot; if not get a new surgeon who has a lot of gastric bypass surgery experience. 

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This is a personal choice and your Dr. should discuss with you the pros and cons to both.  I had chose the RNY in the beginning and on the day they scheduled me for surgery I changed to the VSG.  I have severe arthritis that has taken out both of my hips and I have back issues so I need to be able to take ibruprofin , aleve or any meds to help with pain that I would not be able to take if I would have had the RNY.  I do have reflux but I am on meds and am having no issues now. Good luck on your journey !!

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I chose RNY due to being 485 pounds. As it was explained to me by my surgeon (a very seasoned, well respected professional in the field) VSG would be useless for me. Especially since you can stretch the pouch in a VSG much easier than you can with RNY, eventually making it as large as your original stomach. I have experienced dumping once in 2-1/2 years. I haven’t had heartburn in 2-1/2 years. I’ve lost over 330 pounds in 2-1/2 years. I’m pretty happy with the choice to go the most drastic route. It works if you are dedicated. Like previously mentioned, this is a very important decision. You need to know what lies ahead. A life of vigilance and discipline. The payoff is phenomenal. Best of luck to you!

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I chose RNY largely because I had Type 2 diabetes, due entirely to my obesity. RNY usually normalizes blood sugar immediately. I was on 2 diabetes meds going into surgery, 2 days later I was off them all. My current blood sugar labs are perfect.

Otherwise Res Ispa does a great job above breaking down the main bullet points.

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I was diabetic and that was a major factor.  But I agree with Geoff (Res).  I’m coming up on 5 Years this week and have had zero complications, maintain my weight and it’s the best decision I ever made!  I didn’t want anything taken out of my body and I wanted the quickest weight loss.. 

Either surgery will work if you stay on your surgeons plan.  But you can defeat either surgery one bite at a time!  

You look like you are doing a fantastic job in losing weight!  Research which is best for you..

Edited by Cheesehead

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I chose the sleeve mainly because I don't want to risk malabsorbing nutrients/vitamins that I need on down the road. Plus, it is true that they do not remove anything with RNY but, the part of the stomach that is bypassed is also no longer accessible for testing to surgeons/ drs if a person were to have issues down the road.

These are my personal reasons for choosing sleeve over bypass. I have read hundreds of posts around the net. There are plaenty of people that started at your size and more that chose the sleeve and lost all of their excess weight. Either surgery seems to be what you make of it.

Good luck choosing!

 

ETA- I have read a few posts from people that are young. Their surgeons actually recommended sleeve surgery because IF they did have the issues sometimes caused by RNY, they would have a long time to have to deal with it. This is not my opinion, just things that I have read and noted.

Edited by Readytobeme

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I might have gone with the sleeve if it had been an option for me.  But for all the reasons @Res Ipsa shared above, plus my own medical issues, RNY was the way I had to go.  I had such severe GERD before surgery that I had developed Barrett's Esophagus, which has a very small chance of developing into cancer if the GERD is not treated and resolved.  The sleeve increases GERD in many people, to an extent that is difficult to control - and the medications used to control it have some long-term side effects I'm not interested in experiencing.  RNY typically cures GERD. 

I also watched my father, and then one of my brothers, suffer from severe diabetes.  My father had endless struggles with his diet and was on four different medications, including insulin, before he passed away.  My brother died from diabetes - he underwent a procedure that was meant to clear an obstruction and allow freer blood flow to his foot to help with an infection.  Without the procedure, he was facing amputation of his foot within the month.  Part of that obstruction floated loose, formed a pulmonary embolism, and killed him.  I didn't have diabetes when I had RNY, but my A1C was hovering too close to 6 for my comfort.  Since RNY normalizes blood sugars, this was pretty important to me, too.

I have pretty severe health anxiety at the best of times, so opting for a surgical weight loss procedure in the first place was coloring waaaaaay outside the lines for me.  Choosing the one that changes your insides the most, which is how I view RNY, might have been difficult if not for my personal medical needs. 

As it turns out, my RNY was uneventful, I've had no complications, and my weight loss has been ahead of the curve (my PA tells me!) even for RNY.  So I'm very happy with my choice, even though it wasn't really a choice for me!

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On 1/21/2018 at 1:13 AM, Michael_A said:

I chose RNY largely because I had Type 2 diabetes, due entirely to my obesity. RNY usually normalizes blood sugar immediately. I was on 2 diabetes meds going into surgery, 2 days later I was off them all. My current blood sugar labs are perfect.

Otherwise Res Ispa does a great job above breaking down the main bullet points.

I really love this post Michael. I have diabetes and I am keeping my fingers crossed that once I have gastric bypass, hopefully the end of March, that my diabetes issues will fade away!

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On 17/01/2018 at 11:42 PM, Belia1227 said:

Hello I am new here and would like some advice regarding RNY. I am all done with prerequisites and thinking bout the sleeve. I do have lots of weight to lose. I was wondering why your chose RNY over sleeve. Starting weight 420 current weight 366. It has been hard these last 6 months. I want lasting results and be healthy.  TIA

If you want lasting results, it seems to me that you should be really researching the bypass option, as it will help you stay on track by giving you complications if you eat wrong. Obstruction, constipation, and dumping syndrome, just to name a few. Both options are still great mind you, but like mentioned above, you have to do what feels right to you. I had a VSG done last December and am very happy with my choice, dispite some complications. Please let us know what you end up deciding is the best choice for your lifestyle, and keep up the great work! You are going to feel amazing when you reach your goal :)

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I chose sleeve mostly because I wanted to preserve normal function and did not like the idea of my intestines being re-routed.  I wasn't crazy about removing 75% of my stomach permanently but the more I read about it actually removing the stretchy portion of the stomach (making a sleeve very unlikely to stretch) as well as the hormone secreting portion, the more I came around to the idea.  Plus, I have arthritis in my neck and torn rotator cuffs so wanted to be able to take NSAIDS when needed.  

Bottom line is you can be successful with either surgery (and there are loads of examples here) as long as you follow the program.  The procedure matters less than how well you stay on plan. Pick an excellent surgeon that you trust, talk it out with them and then stick to it, you'll be on your way to a new gloriously healthy life!

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