Decisions

thank you. that is what i was thinking too. He would know best

I had the same battle too I couldn't decide but I discussed it over with my doctor and I am comfortable with my decision to have VSG.  He told me there is a lot less side effects with the sleeve v rny and he assured me that if I Am one of the people t hi is didn't work on we can explore revision but he didn't believe I would ever need a revision.

I agree wholeheartedly with what Gwen said, those pretty much being my reasons too. I primarily did not want any re-routing of my digestive system done. At 6 months out, I am extremely happy with my weight loss progress! :-) Kay

If you are going to get a malabsorptive procedure at a high BMI, a lot of research suggests the DS is far superior - though not everyone can get it for various reasons.  I wrestled with getting the DS over not; being around Chicago, some of the best surgeons in the country perform it at the University of Chicago and the opportunity is right here.

My surgeon did his residency at U of C, so he was trained there extensively, and he suggested the DS, the bypass, or the sleeve would do what I want, but that he had reservations about the extreme nature of the DS when I had already done well for several years with weight loss.  He refused to do a lapband outright.  We settled on the sleeve due to my schedule and health needs.  I also was very leery of the vitamin regimen, and I was not sure how diligent I would be able to be.  I also could not afford to be out of work for three weeks.  I had thought about waiting a year and a half to be able to get the time off/funds to then take 2-3 months off and get the DS, but my health issues were precarious.  I have gone from 12 pills a day to 2 with the VSG, and my surgery was only June 22nd.  

Going back to the bypass, I wanted a permanent procedure.  It's true on one hand that, logistically, you aren't going to easily reverse a gastric bypass.  However, I know how my clever brain works.  I wanted the psychological idea that most of my stomach was permanently gone, and that I had to change no matter what.  This has been super helpful the several weeks since surgery.

It is possible I will need a revision in the future.  My surgery weight was high (401) and my highest weight was worse (over 740).  If so I will choose the DS hands down.  While it's best to do the DS all at once if you can I think, for me my decision has done amazing things for my health.  I follow up with my counselor and nutritionist regularly, and have had pretty great success.  The days when I have issues or might make bad food choices I email my counselor or one of my good friends to get it out, and this has meant I haven't made any crappy choices yet.  

People have been successful with all of the surgeries.  The RNY has a lot of successful patients who eat very healthy, same as the DS, and have no nutrition issues because they manage them well.  With your knowledge of habits, you need to do what is best for you.  

I debated between VSG and RNY as well. I opted for VSG for a few key reasons - VSG is less invasive and I was worried about reactive hypoglycemia with RNY. I did have GERD pre-op and was a little concerned about it getting worse after the VSG. Thankfully that is not the case for me and I no longer have GERD symptoms and don't take any GERD medications. If I was diabetic I would have done the RNY though.

I was at first considering Rny, then waited 2 years, then immediately knew Vsg was the best choice for me for the following reasons:

- Everything works as intended, just less stomach

- less invasive, a little safer

- less issue with malabsorption of vitamins and such, a big deal for me as I struggle being cosistent taking meds (ADHD)

- able to take Nsaids (asthamtic, arthritis, allergies, cancer... didn't want to rule out options if needed in the future)

- loss of ghrelin compared to rny losing the malabsorption of calories after 2 years.. a better fit

- able to revise to rny or ds should that have been an issue

- no rerouting of intestines. I have an irrational fear of colon cancer due to family history and current cancer status and so just don't want to mess with it

- my surgeon indicated that his patients lost nearly the same amount as the rny patients (within 5%)... by 1 year later he indicated the vsg group and the rny group both were comparable

- faster recovery

The one issue that leaned heavily toward Rny was that it was better for the diabetics and the dumping forced folks to stay away from sugar... both were issues for me and hence the surgeon recommended rny. I am glad I went vsg.