Switching surgeries

Medical professionals consider a lot of things when they're recommending one treatment over another. It's always good to get them to completely explain their thought process. The burden for the medical team is to obtain informed consent, and all too often in my opinion the patients are not adequately informed. So keep asking questions until you're satisfied. This is a permanent solution, so there's no taking it back... to me that increases the need to fully understand all of the potential consequences of the decision before making it.

That being said, if your surgeon has a preference for VSG but is recommending RNY, I wouldn't discount his recommendation just because the primary reason he gave doesn't make sense to people who aren't looking at you as a patient and privy to your entire medical history and presentation. The consternation here points to more questions to ask, certainly... but if you trust your surgeon and team, don't discount their recommendations lightly. Ask more questions, absolutely. You need to be 100% sure of the decision and fully understand it. My money says there's more to his thought process than just the vitamin issue, though it may be one of the top issues he's considering.

That you are having absorption issues with both D and Calcium may be underlying the surgeon's advice. The two are interdependent, and as you have stated, may be indicating something going on that they haven't been able to identify yet.

While there's a lot of people sharing horrible GERD experiences with VSG, there's lots of people who have no issue. Keep in mind that most of what you hear about are the bad experiences. I actually had mild GERD prior to VSG, but it was easily controllable with OTC medications and we suspected it was mainly obesity related since my surgeon didn't find a hiatal hernia or the like during my endoscopy.

Because of other reasons, my team (whi*****luded my surgeon and my rheumatologist) recommended the VSG for me, and was up-front about the possibility of it worsening my GERD, but the pros outweighed the cons. I have had no issues with GERD. Granted, I am on a PPI, likely for life, because of the medications I take, so that may be heading off possible underlying issues.

There's a lot of belief that because the RNY is held out as the "gold standard" that the VSG is not as good of a surgery. I don't share that belief. I believe the RNY is CURRENTLY the gold standard, mainly because of the many years of experience and data we have on it. The VSG is shaping up to be a good surgery as well by what data we have on it so far. I don't know that the VSG will become the "gold standard", if I could tell the future I'd have winning lotto numbers. But the data so far is looking really good. At the risk of starting a surgery war here, I believe that for a lot of people the best surgery is literally a coin toss. Individual patient history is what points a surgeon toward one or the other.

Order Biotech dry D 50k. That will get your levels up most likely and more cost effective I bet. I take 100k/day but I had DS.

A plus to the sleeve is if for some reason down the road you start gaining (hopefully not !) you can be easily switched to a DS.

Good luck either way and keep an eye on those vitamin levels

Obese people are chronically deficient in vitamin D. Probably almost all WLS patients were at some point - it is that common, and also that underdiagnosed. If you are deficient despite supplementation, it could be for confounding reasons, like Celiac. I mean, my vitamin D was like 6 pre-op because of the Celiac, which also affects calcium and other absorptions, too. Having said that, vitamin D deficiencies cause calcium deficiencies frequently. It could be that you have zero issues with calcium - it's just that you can't absorb it without the D, which you need. As others mentioned, skip the vitamin D that is oil based and ge****er miscable D. Even with Celiac, that caused mine to drastically improve.

The RNY malabsorption, and the DS malabsorption for that matter, is a non-issue if you supplement and eat correctly. Heck, I've seen DS and RNY patients who are super diligent and never had issues, and I've seen VSG and lapband patients with severe deficiencies.

IANAD and all that. However, I have to say I have never experienced someone switching surgeries away from the RNY or DS even, because of D issues. It's a bit unconventional.

I went to the surgeon wanting VSG, after reading about it because RNY scared me. I did have mild GERD. The surgeon surprised me and suggested that I consider both, then make my decision (she felt I would do well with either). That threw me in a spin for a while and my reading on OH got me scared about VSG and GERD. In the end I had VSG (because I still felt most comfortable with it from a surgical/complication standpoint) and had a hiatal hernia repaired at the same time. The hernia was probably causing my previous GERD since I haven't had any since (though I know it is still a risk).

I made my surgeons goal at 6 months and the weight I'm at now at 9 months out (BMI 20.4).

Do not be concerned about the "initial boost." WLS is a long-term play. The more you care about the short term, the less, imho, you understand what to expect post-WLS over the course of the rest of your life. I suggest that you go back and read your post from the perspective of being 5 years post-WLS and you might feel differently ((and more positively)about your surgeon's recommendation.

One good thing about the sleeve, is that if you have trouble, long-term, keeping the weight off and need a further WLS (I hope you do not) is that the sleeve is an easier revision to a DS.

PS - I had RNY and my friends who both got the VSG lost the fastest and the slowest. I, with the RNY, lost in the middle.

Best of everything on your journey.

I think you will be happy with the sleeve. After nearly 8 years I have no regrets and ally vitamins test fine. I do take double vitamins and calcium as per surgeon's instructions. Good Luck. Diane S.