Here's why I'm leaning toward VSG. What do you think?

I got my inurance approval (Yay!) and am going for pre-op appointment on Friday. I am waiting until September for surgery because I just have too many work and family commitments to do it sooner.  I am 48 with about 100 lbs to lose. Although the surgeon is pushing RNY, here are my reasons for being more comfortable with VSG that I plan to discuss:

• I get migraines for which I can often keep under control with  Excedrine Migraine (contains NSAIDS)
• Getting a year or two of calorie malapsorption for a lifetime of nutrient malapsorption doesn't sound like a great deal.
• Likewise, dumping may be a useful deterrent with RNY, but hit or miss if you will get it.
• Seems less invasive all around.

Any thoughts? After a lifetime of struggling with my weight, I am very excited (and a little nervous) to be taking this step!

I also chose the VSG, I'm scheduled for August 5.

You are not supposed to take NSAIDS with the VSG either (at least according to my nutritionist and surgeon). So, that's kind of a bummer, because I have taken the same thing for my migraines.

I am all for the less invasive surgery as well! And depending on how or what you eat, there is something similar in experience to dumping with VSG that I've read about people coming up against.

It's all just really your body and your body's response to it all. I figure, if you work with it you can't lose!

What is your NUT and surgeon's reasoning for no NSAIDs?  As being able to take them is a reason why many choose VSG.  (And the reason that RNYers can't take them makes no sense with the VSG.)

It's been said that VSG can tolerate them a little better, but your stomach isn't producing the same amount of mucus that protect it from the NSAIDS, so they're still not recommended. I'm assuming they think people who can't handle moderation with food probably won't keep moderation with anything else either, not sure. But in a normal stomach, it's not even recommended that you take them for long periods of time regularly because of ulcers. Smaller stomach still susceptible to ulcers, just more dire if they happen, so I'm assuming they're keeping people safer by saying don't do it. If your doctor says otherwise, that's always the opinion to follow though! Which is probably always the safest anyway. :)

Very interesting, thank you!  

My surgeon told me not to take them because I had an ulcer pre-op which is sad times :P

Your points for the VSG versus RNY are valid and important not just short term but long term post-operatively.

Why is your surgeon "pushing" you to get RNY?  It is a personal decision and YOUR decision.  From other members' posts, there are some surgeons that will push for one procedure over another.  Sometimes it is for $$ or their experience in one procedure over another.  Not saying your surgeon is doing that but something to ask him/her about as to why the push for RNY. 

You've definitely done your research in the Sleeve.  Your points #2, #3, and #4 are

OP should definitely find out why the surgeon is pushing for RNY... It is not always totally a personal decision solely... Another important reason doctors push one type over another is for specific medical reasons.  It is very important that you know why your DR recommends one over another - it could be a very helpful piece of information. He should be able to give you specific reasons if he has them.

I had my VSG 2 years ago for all the reasons you listed above and I'm happy with my choice.  My surgeon never pushed me towards RNY, with "only" 100 pounds to lose he pointed me towards the lap-band and VSG.  I choose VSG over lap-band because I was reading about a lot of people that began having complications about 2 years post op and had to have it removed.  I also figured that if you go RNY, there really is nothing else to do if it doesn't work for you.  With VSG if I wasn't losing weight I could have applied for a revision for something more invasive.

My weight loss was considerably slower than people I've known with RNY.  It came off FAST for the first 6 months and then I plateaued for months, it took me 18 months to lose my 100 pounds.  But I feel like with slow controlled weight loss that my weight is more sustainable.  A number of my co-workers with RNY have gained nearly everything back.  Unlike me they relied on reduced absorption to manage weight loss and they didn't pay attention to calorie intake.  I did and still do count my calories every day.

I will note that currently I'm anemic and my GI is saying its a result of the sleeve... I disagree, (I was occasionally anemic prior to surgery, but never this severely) but until I have another cause I'll have to defer to him.  I take NSAIDS for migraines as well and I haven't had any problems EXCEPT I need to take it with a TINY bit of food (a saltine or two) and do your best not to lay down for an half an hour afterwards.

I had a consult with the surgeon last week. He said that I'm a good candidate for both the RNY (bypass) or the Sleeve. He said that for people that take NSAIDs (non-steroidal anti-inflammatory drugs like Advil, Aspirin, etc.) daily for pain relief, the sleeve is better because he said that NSAIDs can cause problems (ulcers) in the small bypass pouch. However, for patients who have heartburn or acid reflux, these conditions can frequently get MUCH worse if you have the Sleeve operation because it's just a straight shot from the new vertical sleeve stomach back up the esophagus. With the bypass the part of the stomach that produces acid is no longer attached to the esophagus.

I take a prescription NSAID once or twice daily for back pain, but I am on other non-narcotic, but non-NSAID meds for back pain. And I take a medicine for acid reflux. 

So what I'm trying is to go without the NSAIDs for awhile to see if my back pain will be tolerable if I have the bypass surgery and have to give up the NSAIDs completely. 

The surgeon said patients who have the sleeve operation get some relief by taking acid reflux meds or antacids. But if left untreated the heartburn/reflux can get REALLY bad. 

So since my reflux is already bad at times, I'm 99% sure I'm going to have the bypass done as long as I can give up the NSAIDs. I just couldn't bear my reflux to get worse and be more frequent. 

If you have any questions about this stuff....ask your surgeon or his staff. I don't have any medical background, I'm just repeating what my surgeon said. 

Good luck with your decision.