A Crossroads:The Sleeve or Roux and Y???

I've completed my options program, seminar and  support group and I guess i am at a crossroad. I am 32 years old, weigh 301lbs and set a weightloss goal of 100 lbs which i am determined to accomplish. My consolt with my surgeon is this Tuesday (Aug 30) and  as of now, I am conflicted on whether to go thorugh with the sleeve or the Roux and Y. Both have risks but I know the RNY will result in greater weightloss. If anyone out there can share their chosen procedure along with the pro's and cons, I would greatly appreciate it.

 I had 100  lbs to lose  and i  was only offered  an RNY  .   since i could  BARELY  qualify    i felt  i would be laughed  at  if i wanted a DS   .....which i knew i needed  .

in retrospect i wish i had   insisted on  a sleeve .


Why ?   well the malabsorption stops  with the RNY  18  months post   100  % .   Then U get   blood sugar swings  .. reactive hypoglycemia   which means U have to eat  every few hours . Which means U eat extra calories and REGAIN  .

 RNY  ers are REALLY prone to regain .  

I'd ask for a DS   frankly if it was ME   and i had a chance to do over  .  

I f U cant get that id settle for a sleeve .


(((())))))))   good luck Hun 

 I agree with Mini-Me's-Mommy. RNY isn't worth it. There is regain that is typical and many do regain all of their lost weight. Obviously I'm one of them. 

And the dumping? So not worth it. Don't ever, ever be fooled with the whole, "Dumping is a good thing, it will stop you from eating sugar," crap. Dumping isn't a good thing. The pyloric valve exists for a reason. Reactive hypoglycemia is a serious problem. Some folks have had seizures from the drops in blood sugar. Seizures!

Oh, and there's the food getting stuck, vomiting...bleh. 

It sounds like you actually have a choice in the matter where insurance is concerned. When I was contemplating surgery, my insurance wouldn't cover the DS. (No mention of the sleeve that I remember). According to them, the DS procedure was considered experimental. That scared me away from the DS, but if I were smart, I would have researched it better and made a more informed decision, not let my insurance decide for me. 

Now, obviously, due to my bad experience with the RNY, I'm biased. Maybe you won't have bad experiences if you choose the RNY. I don't know. But honestly, I think you'd be less likely to have trouble if you go with a sleeve.

My two cents. Take care,

Lynda

Wow... It was unfortunate that the insurance had a bigger hand at your decision than you wold have wanted. I think that the sleeve might be a fitting choice even. My PCP did say that if a revision has to be mae, it would be the better choice. Thank you for your input.

 Yes, it's sad how much the almighty dollar rules my life. Oops. I mean the LACK OF the almighty dollar rules my life. 

Others here were smarter than I was. They chose the procedure they wanted and fought their insurance companies to get it. I wish I'd done that. 

Oh well. Live and learn.

Sounds like the sleeve might be more fitting than. All i've heard is bad things about the RNY except for the You Tube testimoni9als that i've watched. I guess cause they were less than a year out. thank you soo much for your input, I appreciate it.

 Yeah, it is important to realize that the first year or two after RNY is pretty good. Even if you're having complications like stricture, or dumping, etc., the weight is just sliding off almost effortlessly and you feel better because you are becoming lighter, which translates into more energy.

Ah, the honeymoon period...


But then at four or five years out, things change. Your pouch stretches and you can eat more. Your stoma widens, you don't have much restriction, and you can eat more. And then your intestines adapt and your metabolism becomes much more efficient with the calories you consume, i.e., you don't have to eat very many calories for your body to gain weight. (I believe this is true with the DS as well, though to a lesser extent). And this becomes a problem because, well, because you can eat more. 

Then, of course, there is the dumping: both early and late. The early dumping is obvious. You eat something you shouldn't, it enters your system too fast, and you dump. The late dumping is insidious, in my opinion. You eat something you shouldn't (or maybe it's something that's supposedly OK, but that your body doesn't agree with), it enters your system too fast and your blood sugar spikes. Your body responds by pumping out lots of insulin, but then too much blood sugar is removed, and you crash a couple of hours after eating. 

In some people, the reactive hypoglycemia is so bad, they have to have all or part of their pancreases removed. Though this is rare. (There's a name for reactive hypoglycemia that's this bad. Anyone know what it is? I can't remember.) There are people (RNYers) here on OH who have had seizures from low blood sugar. I haven't experienced seizures, but I've had some scary episodes. I have to be very careful not to repeat those episodes. Dumping sucks.

In my understanding, RNY seems to work mostly by restriction, with a little bit of initial malabsorption that disappears over time. The sleeve will give you restriction but will leave your pyloric valve intact. Thus no dumping. (Did I mention dumping SUCKS?) 

The Duodenal Switch (I'm assuming you're not familiar with this procedure) is the sleeve, with some rearrangement of the intestines. The intestinal rearrangement gives you malabsorption, but more so than with the RNY. 

Now, I'm not an expert on the DS, others here can help you better than I can, but I can tell you that if you have metabolic syndrome, the DS fixes that. 

Here's a wiki article that explains metabolic syndrome:

http://en.wikipedia.org/wiki/Metabolic_syndrome

I sure hope this post helps you. WLS is a big friggin' deal and it's best to get it right the first time. Good luck, 

Lynda

Thank you for your input. It's nice to hear that i can get support here... My support group was not that helpful.

Sounds like you have Kaiser.  Why are you limiting yourself to those two surgeries?  (You've left out the most effective...if you have a LOT of weight to lose...and that 100 pounds could be a lot or not depening on whether you're 6'7" pr 4'11".)  What is your BMI? 

I am a Kaiser Patient and my BMI is 43. I'm hearing alot mix reviews about the RNY but  the concensus is that there are more cons than pros.  That other procedure, are you talking about the lap band??