I need some advice

I have found that when i must take any NSAID , I take my stomach protector with it.( suggested by My PCP, but not a RX.,). I take prevacid 30mg, 2 OTC's, it works quicker for me...and w/history of 2 intestinal blockages caused by inflammation/gas combos. I must be on top of any gastric irritations. Keep in mind it will prevent part of your absorbtion.. Rheumatoid,Lyme and cold fronts do not abide well together. Take care, follow Drs orders for your situation.

Hello! I wish you the best on your weight loss journey.

Is going to another practice a possibility?

You also said, "I really dont want to go through with it if I have to do the Gastric Bypass." Please don't then. Find another practice. I started with a VSG which I loved and lost 80 pounds. However, I developed complications and have had four additional surgeries on my stomach. One of them was a conversion to a gastric bypass that I didn't want. Now that I am still living out the chronic complications I have a lot of regret for not looking harder for someone else.

Best wishes!

You may want to post to the Canada group. In Ontario, OHIP will definitely pay for RNY but you have to have a really good reason to convince the surgeon to do a VSG - it is usually related to having to take NSAIDS for the rest of your life, if you have a bowel disease and "re-routing" your intestines would cause issues and/or having scar tissue from previous abdominal surgeries among other things. It is up to the surgeon, they don't really give you a "choice". The other option is have VSG done privately and pay out of pocket but that costs $20,000. I don't want to discourage you but it is a challenging situation.

Canadian healthcare rarely approves anything but RNY. You'd have to convince doctors of the medical necessity for VSG.

Those that insist on sleeve over bypass have to go the self-pay route. Many go to Mexico.

Having said that, there is no reason npt to go with bypass. Especially with a history of reflux.

Be sure your rheumatologist weighs in on the decision. With the RNY they'd have to have an alternate plan for NSAIDs and steroids to treat your lupus. I have psoriatic arthritis and my rheumy wanted me to have the VSG for several reasons related. First, the stomach tissue that is removed with VSG and not with RNY plays a large part in the inflammatory process. So inflammation levels will go down in a different way with VSG than with RNY. Second, she wanted to reserve the ability to treat me with NSAIDs and steroids and while they are not recommended for VSG, the risks are higher with RNY than VSG.

With a complicated medical situation, your entire medical team needs to weigh in on the choice.

Hi Jhadere,

I had a VSG at Humber just last week.

I had a VSG because of MS. My surgeon fought me on it, right up to the OR. But I feel it was right for me. I actually spoke with the pharmacist and the internist, Dr. Glazer, and they both supported VSG.

Whether it's RNY or VSG it wil be good for you, but of course you want the optimal outcome for all aspects of your health.

Second post - I agree that your rheumatologist needs to be involved. Can they write a letter?

Also I want to throw out there that my medications are NOT available in any other form, nor can they be broken open or crushed. Most of my meds are delayed released. My surgeon just didn't seem to understand how important that was. Humber's pharmacist sealed the deal for me.

I had RNY in Ottawa last Dec. I have Wegeners Granulomatosis, stage 4 renal failure, high blood pressure. This was the surgery suggested to me and I have no regrets. 30 lbs away from my goal weight. I have taken many of the same meds and luckily for me, my disease is in remission so no more nasty pred or imuran. My kidney function has improved from 18% to 24%.

my advise to you is trust your surgeon. He/She knows what is best.

Hi! I don't have Lupus, but had a VSG 5 years ago. I developed severe GERD and had ulcer. I just recently had to be revised to a Bypass. I was not ever wanting the bypass from my first surgery. I took meds too with the Sleeve. I would be completely aware if you have a Sleeve you may end up with a revision to the bypass. I know a few people who have had to. Just my experience. Good Luck!

I am the weirdo, and I had severe GERD post-op with the sleeve - but it is not my sleeve entirely! I eliminated dairy and eliminated the GERD, in my case. If you have Celiac, wheat also can cause GERD. Anecdotally, there are many individuals who eat higher carb/poor diets and then switch to a lower carb diet and see a remission of symptoms.

Dr. Prachand, one of the best bariatric surgeons in the United States (and most experienced) published a study where about 47% of the group of patients had an RNY and had immediate GERD resolution post-op - but about 28% of the DS patients, who also have a sleeve gastrectomy - had resolution of GERD post-op.

Part of GERD is mechanical, you see, and extra weight puts pressure on the organs in addition to diet choices.

About 25% of people who get a sleeve gastrectomy (depending on the study) will develop GERD. Quite honestly, no one knows if it will cure or give you GERD - that is information we just do not know, sadly. Also, you can have silent GERD, so you can/may still have it even if you are asymptomatic.

Weight loss wise, after so much time the VSG and bypass are far more equivalent, interestingly. The DS still comes out ahead quite a bit. I would carefully investigate all the options and make an informed decision. None of us are doctors, though many of us are knowledgeable. Many people have excellent life-long results with an RNY procedure, and they are very successful, though!