Deciding between bypass or sleeve
You do have to be diligent with your vitamins, but there are vitamins you should be taking with VSG too. Now that I am a year out (tomorrow! Yay!) I have to say, it is not that bad. You get used to the routine. I chose RNY for several reasons, one main one was that I wasn't sure restriction would be enough to get me where I needed to go. I had stuck to restrictive diets and I still was losing anything significant at this point of my life. I wanted the malabsorption to help get me where I needed to be. Having a large amount to lose I wanted to go the tried and true surgery. I know many people are successful with VSG but I wasn't sure I could be. I also trusted my surgeon, and He thought RNY was best.
Cynthia 5'11" RNY 7/23/2014
Goal reached 17 months. 220lb Weight Loss
Plastic Surgery Dr. Joseph Michaels - LBL and Hernia Repair 2/29/16, Arm Lift, BL, 5/2/16, Leg Lift 7/25/16
#lifeisanadventure #fightthegoodfight #noregrets
on 7/22/15 12:37 pm
I wanted the VSG, but ultimately went with the RNY because of my severe GERD. The RNY can cure GERD while the VSG can make it worse or cause it in people who haven't had it. I've been off a PPI since the day of surgery with no more nausea spells like I was experiencing multiple times a day due to acid. Without GERD, I undoubtedly would have gone for the VSG.
My husband had the VSG 2 weeks after my RNY, and we're both really happy with our decisions. We have the same vitamin requirements and eat pretty much the same foods (he can eat a larger volume of veggies than I can, though). The biggest side effect for me has been chronic gas, but that was an issue before surgery too, so I can't blame it all on the RNY.
From what I have read the results weight loss wise is almost the same at 5 yrs out. With the RNY you only have malabsorbtion for the first year or 2 then the body starts absorbing calories again. So it is short lived but the weight loss with the sleeve is also constant loss from the small size of the sleeve but with the sleeve you don't have the vitamin issue as much because you absorb all the vitamins. You will still need good vitamins with the sleeve too but it is because you can't eat enough food to get all the vitamins you need so you don't need as many as a rule. Personally I prefer the sleeve but wouldn't refuse a RNY if someone gave me a free one.
I first had WLS surgery in late 2010. I wanted an RNY and this is what my surgeon and PCP felt was the best choice for me, but the insurance I had at the time would only cover the band, so I went with that. It was a dismal failure in my case and a year later it slipped and I had to have it taken out. Fast forward 3 years to now. I am still significantly overweight and while I've managed to keep off the 50 lbs I lost during my year with the band, I need to lose a whole lot more! Up until a few years ago, other than being overweight, I was very healthy. Then things started to change - one thing after another and now I find myself with several co-morbidities that are making my life miserable. I am 64 years old and have a very slow metabolism. I now have better insurance that will cover the RNY and so after much thought and research, I have decided on that. They say gastric bypass is the gold standard for WLS, and so I'm going for the gold. I was leaning toward the sleeve for awhile but after a good long talk with my surgeon about my age, slow metabolism and the difficulties I have losing weight, I decided to take his advice and have the bypass. I know 3 people who have had sleeves. One has lost almost everything she needed to lose and is very happy with her sleeve. One has lost very little, is unhappy and is thinking about a revision. The other lost about 1/2 of what he wanted/needed to lose but then regained every pound. He is now waiting for approval for a duodenal switch. On the other hand, I have 5 friends that had bypass surgery and all have had phenomenal success and lost all they needed plus more for a couple of them - with no complications except an ulcer for one of them. After doing all my own research and comparing what I've seen amongst friends and acquaintances, I think the bypass is best for me. I've also seen several people with sleeves at the support group I attend that are hoping/planning to get revisions to bypass for various reason. One thing my surgeon did say - if you already have problems with reflux and heart burn, the sleeve is NOT the right surgeyr for you as usually it will make that problem get worse.
I have already been through one failed WLS - I'm not up for another. So, I'm at peace with my decision for the bypass. Yes, it's scary and there are possible complications - but this is true with any of the WLS options out there. One word of advice - research and find a reputable surgeon!! One with lots of experience doing WLS and whose results are an open book for anyone to research and find out. I have read many posts from people who have had problems with all 4 types of WLS and in many of those cases, they found out later that they had crappy surgeons!!
Good luck in your journey no matter which surgery you choose.
Warmly,
Catherine
I chose the sleeve. I don't have metabolic issues, whenever I cut back on what I ate, I lost, my nemesis was always sugar, so no wls would take care of that, I have to take care of it.
Besides at the 5yr mark the stats between the 2 was pretty even, but the malabsorption of nutrients is for life with the rny. I wasn't too crazy about that, but it looks like getting the vitamins in isn't much of a problem.
I was concerned about getting severe gerd which is a risk with vsg, but the rerouting of intestines I really wasn't crazy about. I'd consider rny if I ever did get a bad case of gerd, but so far so good.
I'm happy with my choice.
No one surgery is better than the other, what works for one may not work for another. T-Rebel