RNY or Gastric Sleeve for Osteoarthritis?

I am a 57 female, weighing 240. I am 5'4in. I have severe osteoarthritis in both ankles, knees and back. I have been taking meloxicam occasionally for pain. I really want to have the RNY but don't know if I can take the meloxicam afterwards. Which surgery should I go for? If I go for the gastric sleeve, will I lose just as quickly? I go for my WLS doctor's appointment on Monday but wanted your opinion first. Thank you!!

You answered your own question.  With severe osteoarthritis you need to be able to take NSAIDs.  As far as how fast you will lose the weight, I understand the sleeve may be a bit slower but in the end all that matters is that you take off the weight, not how fast you do.  God willing, 5 years from now you will have lost all the excess weight and are well into maintenance no matter what surgery you have.

With the sleeve you have fewer risks because there is no malabsorption.  With the RNY the malabsorption lessens after a while and at the end of the day you are left with a purely restrictive procedure but complications form not absorbing all your vitamins for life.  Plus restrictions on the medications you are able to take.

All forms of WLS are a tool to help us eat right.  It is up to us to make good choices.  Different surgeries help in different ways.  There are forums for each of the surgeries.  Check them out and ask questions and that should  help with your decision.

I am not familiar with meloxicam, but I know with RNY your use of NSAID pain relievers is very restricted as they can cause an ulcer.  This is more of a problem for RNY patients because if an ulcer appears in the blind stomach, it can be very difficult to diagnose and treat.  VSG doesn't have the same issue because there is no portion of closed-off stomach so normal ulcer diagnosis and treatment can proceed.

When you have your consult, make sure your surgeon is fully aware of your pain situation.  You may also want to contact your meloxicam prescriber and get their opinion and possible alternatives if the medication won't work with your chosen surgery.

Good luck!  :D

Jen

Meloxicam is an NSAID FYI.

The sleeve stomach will suit you better for your need of NSAIDS.  If you're afraid it may not be enough for you, learn more about the Duodenal Switch.  It has the sleeve stomach, as well, so you can have NSAIDS, but adds metabolic advantages, even more than RNY.

Sleeve so you can still take NSAIDS, provided you don't have GERD or some other reason that would make the sleeve a bad idea.

Life without NSAIDs was not an option for me. Migraines, severe pms, and damage that my Dr said is were arthritis would settle in as I age. 

I didn't think the sleeve would be enough for me, so I went for the DS, which has a sleeve stomach, with malabsorbtion, especially of fats. You are a "lightweight", with means you may be able to get by with a sleeve, but I was certain I only wanted surgery once, so I went for the DS.

Yellowrose, we are the same age and I have osteo arthritis throughout my body.  I take meloxicam and for that reason, I am having the sleeve done.  But, since I just had the lap band removed yesterday, it will be a couple months. 

I also want to add, and it could change as I am only 2 days out, that I have hard reflux for years but since the band was removed yesterday, NO reflux at all.  Since I had it well before the band due to medications, Ie xpect it might come back but sure hope not.

With arthritis in so many places, and especially since you say it is severe in some of your joints, I would tell you to not even consider RNY.  Go with sleeve or DS instead.  

No, you won't lose quite as quickly with the sleeve as with the RNY, but after 2 years, you will have lost about the same amount since the caloric malabsorption of the RNY is temporary.  The lack of vitamin absorption and the restriction on NSAIDs, however, is permanent.

I expected to get a lot of relief from my knee pain when I lost almost 200 pounds, but I didn't.  I ended up taking Tramadol, getting steroid injections 3x a year, and getting Synvisc injections twice a year for 5 years AND taking Vicodin for over two years until I finally got fed up and worked up the courage to have my knees replaced.

I understand wanting the weight off as quickly as possible but living without NSAIDs (which is what Meloxicam is) when you have arthritis is difficult.

Lora