Dr. Said RNY

Anyone out there weighing near 220 or less that had RNY. For the past couple of years I thought I wanted the sleeve. I saw my surgeon yesterday and he said due to my comorbidities, RNY may be a better choice for me. I weighed in at 215 lbs yesterday and an A1C that's very high and out of control. I'm beginning to hurt all over now but so afraid to have RNY due to my size. He said that I wouldn't lose too much and he could even do a duodenal switch and I could decide in the next two weeks what I want to do.  Can anyone relate or have been in the same situation?

It sounds like the most major concern is your A1C.  RNY has the highest success rate for sending diabetes into remission.  It can also occur with the VSG, but as far as I understand, if your A1C is out of control as you say, RNY sounds like your best bet.

Jen

The science is very clear on the RNY and A1C. In many cases after the RNY it simply disappears. The sleeve is not nearly as powerful for that. It was a major part of my own discussions. Had I been pre diabetic or diabetic it would have been automatic. 

I'm 5'2 and had my rny may 3 at 198lbs. You will

prob get more feedback if you head over to the lightweight surgery board on here or the rny board ! I'm definitely not worried about losing to much, my loss is 27 lbs in 3.5 months so it's slower than someone with a lot more to lose. Reading daily on the boards, it's easy to see that regain and increasing your calories to slow or eat in maintenance level is Not hard to do and very very rarely will someone lose to much weight. 

How persistent is your weight problem - that, for me, also helped decide.  If you were heavy in first grade and the best you ever did was yoyo- I would get the DS, which has the best proven results.  If you were normal weight as a child and gained your excess weight later in life, then you have a change of RNY or VSG.   Given the percent of weight regain with both the RNY and VSG, I wish I would have gotten the DS (or at least had the option of considering it). 

I am a little less than 2 years out, so I have not experienced regain (and am doing everything possible to prevent it), but with RNY or VSG  ~25% of people gaining it all back and ~50% only keeping 50 pounds off after 5 years, I would prefer to have the surgery with the least regain.  Few surgeons are really experienced with the DS (having performed at least 100 DS), so the DS is not an option for many people.

Ask him if either the VSG or the RNY is easier to convert to DS if you have regain in a couple of years.  In the past, I have read that the VSG is an 'easy' convert to a DS (in fact, the VSG was designed as a first step to a DS for people who were not healthy enough for the longer DS operation, and would ge thte DS when they lost weight and were healthier).  The RNY required an open operation, which is much more invasive and risky than laparoscopic surgery. But, his surgical techniques may be newer and he could go RNY to DS laparoscopically now.

Few people lose too much - the far greater risk is not losing all the excess body weight and not keeping it off.

How tall are you?

I'm 5.2 and a half

I'd be leery of doing DS at a low weight. DS ups the malabsorption of nutrients dramatically  and ties you to a stricter vitamin regimen post op. I think you can get a nearly identical result for your diabetes with just the RNY. 

VSG is more of a gamble with Diabetes, I've seen some who it helped, others that it didn't. But remember the longer you've been diabetic, the less likely It will go into total remission. 

Yes, you're right. I wasn't even considering that once he explained it to me. Thanks!

I was 245 when I first approached my doctor about WLS. My insurance only covered RNY. I was just over 235 when I had the surgery. Now, I'm weird and had some healing issues and the majority of people do not experience complications... so don't make a decision on my complication experience as sleeve people also have experienced complications - especially post surgical stuff like GERD. But you can successfully lose just the amount you want to lose with RNY and it has been shown to do a much better job with diabetic issues than the sleeve.

That said, you will have to cut out all sugar, alcohol and the majority of carbs to make it work. The pouch (your tool) does this by restricting how much you can eat and how you react to what you eat. For me, the promise of repercussions keeps me on the straight and narrow when it comes to food.