How did you choose the surgery that was right for you?

So, I'm almost done with my pre-op clearances. The only one left to complete is my sleep study! I have been working my butt off the last 2 months trying to get it all done. 

The hospital says they can put my request in to Cigna this week: with my 6 month diet logs, my psych eval, and one medical clearance (with the promise that the final reports of my others will come). However, I also need to choose a surgery! I've narrowed it down to the sleeve or the bypass. The surgeon's nurse practitioner and the psychologist recommend the rny bypass, but I'm so nervous about the malabsorption issues and the increase in the amount of supplements I would take.

I'm 5 foot 6, 34 years old, and I weight 280 pounds. My goal weight is 170. I have hypothyroidism, high cholesterol, testosterone deficiency, and PCOS.

Can you guys give me some insight on how you decided what surgery was best, why you chose it, and how you are doing as far as your weight loss is concerned (how much and how fast you've lost your weight)? I would really appreciate it!

Thank you!

It is truly a decision I had to think long and hard about. I chose the sleeve. For me, in the end, the lifetime malabsorption of vitamins was not worth the limited calorie malabsorption with RNY. Yes, I still have to take vitamins and get regular lab checks, but there is less risk than I could have had. I also did not want a remant stomach that could not be scoped if necessary. 

I have not regretted my decision a single day over the last year. I started at 347 and in a year have lost 158 pounds. I still want to lose another 30 or so but I will eventually get there. With the sleeve, you do have to realize it is all on you. You limit calories and what you eat. You do the same with RNY but have an added boost for the first year or two. It just comes down to what you are willing to live with. 

This doctor gives his analysis based on the behavior changes you think you can make.  I thought it was a good take.

http://drmatthewweiner.com/how-to-choose-the-right-bariatric -weight-loss-surgery/

Wow! This video was great! Thank you so much. Very helpful. 

My insurance company made the choice for me.

I think of it in a different way. I compare malabsorption to finances. What if you had an opportunity to have no deductions taken out of your paycheck for the next two years? What if you also were given two years of not having to pay for your mortgage, your car payments, your utilities, your credit cards, your groceries, your gasoline, your health care, your clothing, your education, or your entertainment?

The deal would be that you must use those two years to build a sizable savings account and also to learn how to keep that financial advantage and stay out of debt.

Malabsorption gives you a two year break from absorbing all of the calories from the food that you eat. It lets you get on the same playing field as someone who was blessed with a body that never had to fight obesity. For me, it was 30 months before I ever saw the scale move up by even one pound.

The malabsorption did stop for me, but it left me with more than 100% of my excess weight gone. RNY gave me an additional gift of never being hungry again. With no hunger, no excess weight, and a tiny stomach that can only handle a small amount of food, maintaining my weight loss has been pretty easy.

I lover this analogy!

Beautifully put White Dove!

So the malabsorption issues stop? I thought it was something I would deal with permanently. My doctors have been great at answering questions and educating me but maybe I missed this since there's been so much info thrown at me over the last 2 months. 

The malabsorption of calories goes away.  The intestines grow more of the little hairlike structures that hold food against the walls of the intestines.  The food is held there longer so that its calories can be absorbed.  It is the body's way of overcoming the fact that it has less food to work with.

There will always be some vitamin malabsorption because some nutrients are best absorbed in the part of the intestine that is removed.  I have lab work done once a year and if any vitamins or minerals are low then I adjust my vitamins to compensate.  I take a multivitamin, iron, calcium, Vitamin D and B12.  It takes about two minutes a day.  Recently I started using a patch instead of pills.  It is called Patch MD.