VSG and GERD

you are very much right about that. Since I've seen this doctor he barely has listened to anything I have to say and doesn't even look at me or make eye contact with me bc he's staring at a computer. I guess to him I'm just another customer he can make money off of. I've paid $200 for the "package" we're required to buy that supposedly covers the psych Dr. Costs, exercise consultant and dietician as well as some tests. I'm so mad right now. Ultimately it's MY CHOICE, MY LIFE, MY BODY & I'm going to make sure he understands that. If they refuse to listen I'll have to take that loss and, although surgery is something I've been wanting so badly, I might have to call quits on this whole thing.

VSG is the quickest and easiest weight loss procedure.

If you went to work one morning and was given a choice between doing an easy task that took one hour as opposed to a more difficult task that could take several hours and the pay was the same, wouldn't it be human nature to do the quick easy task.

You need to find a surgeon who is willing to do the RNY. If the center you are going to does not have an experienced and willing RNY surgeon, you need to find a center that does.

I had VSG at a very large, nationally 'big name" center of excellence 5 years ago and had previously suffered GERD for about 20 years.

My surgeon gave me the option of VSG vs. RNY but I really wanted the VSG. He was sure that because of HOW I carried my weight, my GERD would be alleviated. I carry pretty much all my weight directly around my belly, and it looks terrible.

I lost 80+ lbs post op and my GERD was almost completely alleviated!!! Yes, I'm happy to report that he was right...however some really bad life events and bad food choices lead to some regain and my GERD resurfaced. I have since lost my regain but the GERD is still irritated, and I continue to take a PPI daily. Hoping that another 10 lbs will do the trick.

I was also thinking because of how I carry my weight ALL in my belly (ugh) that I might be the same way. I'm currently not taking ANY heartburn or GERD medication bc they took me off Prilosec for the H.pylori test & put me on zantac for time being but I hated it. Anyways I'm off it all and my heartburn and gerd is not even an issue right now...so who knows- if I lost enough weight it might go away?!!

I would guess that you're right. if it's gone now you are likely to be rid of it once your weight is gone.

I know that my GERD resurfaced because of the weight gain, because I was off meds and everything...oh well, this is my incentive to keep going and get this last amount of weight off.

Yes, since I started this road to getting surgery (6 month insurance requirement under doctor supervison diet) I have lost 23 pounds and my GERD isn't an issue. I think once I lose the weight more it shouldn't be a problem either.

It's amazing how we are able to talk ourselves into things. Guessing that if we do x, y might happen. It's how we get ourselves into trouble.

Sometimes, we do everything right and bad things happen. I've seen lots of people who lost all of their excess weight, ate a textbook diet, had hernias fixed, and still suffered from horrible gerd. Many went 3 to 5 years after surgery with no gerd, and then it hit like a freight train. That's true for many who never had gerd a day in their life before VSG.

I wouldn't risk having a second surgery down the road. Especially since more and more insurance companies are instituting a one weight loss surgery per life policy. I'd hate to be stuck with that sort of bill.

I would find a surgeon who will do RNY, and be done.

Well it's a difficult decision I'm facing now! I was pretty much set and prepared to be having VSG. I've been going to this weight loss center since March- a few times a month. Its a commitment I've made to get healthy and learn everything I can about the lifestyle change I'll be facing. I've paid around $200 already for the whole package (doctor's visits, tests, etc) so I really don't want to go elsewhere and have to completely start the process over (6months on supervised diet) to get my insurance to cover it.

IF for some reason my surgeon won't perform RNY then yes, I will have to choose a different surgeon but at the same time I am apprehensive to get RNY too- you've failed to mention the long term risks that accompany RNY as well. Hair loss, vitamin deficiency (if you don't take supplements and sometimes even if you do as I've read) leading to malnutrition, Ulcers, hernias, bowel obstruction. It's a bigger surgery, meaning more difficult recovery in hospital right? I'm just really ambivalent and stressed now because I was set on VSG- it just sounded like the better of the choices. But, already having GERD I don't want to risk it resurfacing. And I did read it's very common problem.

hair loss is very common regardless of which surgery you go with - there's really no difference with that, so that's not a pro/con item. If you're going to lose hair (which most of us do), you'll lose it with either RNY or VSG.

Vitamin deficiency is uncommon as long as you take your supplements - the exception being iron. Some people don't absorb oral iron well and have to eventually start getting infusions. Although most of us do fine on oral iron.

those other things you mentioned can happen but aren't very common. The most common issues with RNY are strictures (which happen to about 5% of RNY patients and are an easy fix) and the iron absorption issue (I don't know the statistics on that - although again, most of us do fine on oral iron supplements)

big issue with VSG, of course, is the GERD issue.

both surgeries have their pros and cons - you'll have to decide which you can more easily live with.

If you have already done the supervised diet, I imagine it's very likely that your insurance company would accept that towards the RNY.

Many of the risks inherent to RNY also apply to VSG. People with both surgeries deal with hair loss (google "telogen effluvium"), need to follow the exact same vitamin regimen, and face the risk of ulcers or hernia. If you follow your supplement recommendations exactly, which means roughly 200% RDA on all vitamins/minerals plus bonus iron and calcium, and NO Flintstones vitamins, the risk of developing deficiencies is very low.

The notion that VSG has "fewer complications" only applies to the immediate post-op period of a few days. The long-term complication and mortality risks are very similar.

According to my doctor, the recovery is VERY similar for VSG and RNY. For both operations, assuming they're done laparoscopically, you'll spend one night in the hospital and be home from work for two weeks.

Personally, I am preparing to revise my VSG to an RNY in a couple of weeks due to GERD, though I've never had acid problems in my life before WLS. If I could have solved the problem with a single surgery in the first place, I absolutely would have done so.