Deciding Which Surgery to Choose

This does illustrate the compromises and trade offs that are usually a part of making medical decisions. Some family history of a variety of cancers should cause one to investigate things more closely before committing to creating blind paths in our insides (guys thinking 'like my grandmother's ovarian or uterine cancer is going to bother my stomach! - it can.) There are several "syndromes" out there that genetically link seemingly unrelated cancers (Lynch seems to be one of the more prominent ones these days) so it is worth checking it out if there is a family history.

Likewise on the theme of medical trade offs is the dreaded "no NSAID" advice - the procedures differ in their sensitivity to these medications, with the RNY being particularly sensitive given its propensity toward marginal ulcers; the sleeve procedures less so, though they are still not something to be taken lightly. This another area where choice of WLS can influence treatment of other morbidities (in this case arthritis or other orthopedic problems) so it is something to be discussed and considered if it applies to you.

For the OP, if the heartburn that you have experienced is incidental, something that happened occasionally after a spicy meal, it may not be anything beyond what most everyone experiences from time to time, but it may not be, as well. Likewise, one can have GERD without obvious symptoms like heartburn, so best thing would be to discuss this with the surgeon and maybe push to have an EGD (endoscopy) done before deciding (some programs routinely order them as part of their pre-op protocols, while others don't.)

Good luck (whoever said any of this was simple?)

Update after consult with surgeon.

Thanks again for all of your input. I was able to discuss some things many of you talked about on here (and throughout the site).

I met with my surgeon yesterday and through a lot of discussion and answered questions we decided on RNY.

It feels a little more real now that I know what I'm doing. She wants me to lose 15-20 more pounds before surgery... probably this summer. I've lost 25 so far.

It's a good feeling when we start to have firmer plans.

Getting a good running start going into surgery can really help you reach goal. Anything you can do to prepsre will help greatly in the long run.