RNY or Sleeve
Hi Everybody,
I have been trying to get approved for surgery for a little over a year. Finally, BCBS has sent my approval letter and I have my pre-surgery consult with my surgeon on Tues., Oct. 26.
I am 5'6" and currently weigh in @ 344.5 #. All along I have been thinking I would do the RNY but I have recently learned about the gastric sleeve process.
I would like to know opinions on the 2 procedures and with so much too lose, which is the most likely option to help me succeed with permanent weight loss.
Thanks
Jacque
I have been trying to get approved for surgery for a little over a year. Finally, BCBS has sent my approval letter and I have my pre-surgery consult with my surgeon on Tues., Oct. 26.
I am 5'6" and currently weigh in @ 344.5 #. All along I have been thinking I would do the RNY but I have recently learned about the gastric sleeve process.
I would like to know opinions on the 2 procedures and with so much too lose, which is the most likely option to help me succeed with permanent weight loss.
Thanks
Jacque
The fact is that the surgery choice you make is a very personal one. I can tell you a number of reasons that I chose the sleeve, but they are probably the same reasons that you are considering it. Both surgeries are very effective if you work at them. I CAN tell you that it is possible to lose adequte amounts of weight with the sleeve. I am doing very well with mine. I do have to be diligent and I choose to exercise (though some don't.) I eat within the recommended guidelines, watch carbs, drink water, journal my food, etc. I don't know if everyone does that, but I would imagine that my Dr. would have recommended the same behaviors with the RNY.
Good Luck with what ever you choose. My surgery not only changed my life, but saved it! It works if you work it!
Good Luck with what ever you choose. My surgery not only changed my life, but saved it! It works if you work it!
Thanks for your input. Everyone's thoughts on the options are being weighed before I make a final choice. The folks who have been through the fire have the best knowledge to tell me how they feel about the choice they made and if they would do it differently if they had the chance. Once this is done, it's done for life and I want to make the best choice I can.
Thanks again
Jac
Thanks again
Jac
Hey Jacque,
It is going to be a very personal choice, one that only you can make. My situation, I have been obese all my life, my boyfriend the same. We both arrived at the same conclusion: We cannot do it on our own.
For me, I have reasons for opting for surgery that combines malabsorption with restriction, Roux en Y. My boyfriend seems to be more in need of just restriction - and the Sleeve is restriction without a foreign body involved.
You have to look at how your body works - how efficient it is - as in, how does your body use & store calories. Having hypothyroidism, I grew up with a low metabolic rate (temperature, heart rate, blood pressure) and the way my body processes waste (poo). My boyfriend is very active, but eats too much for his output. I look at it like a mathematical problem, so that is how I came to MY conclusion.
My boyfriend does not want to have his bowel changed, he does not want the dietary issues involved in having RNY, and Banding isn't (in his opinion) enough. VSG simplified is like a permanent band that does not involve the fills needed to reach the same goal. He did not set out with VSG as an option, but when he found out about it, it made sense in his case.
We both belong to support groups that include folks who have had RNY, Band, VSG, DS and even at least one person with a Revision. It isn't always apparent why one surgery would be a better fit, so ask LOTS of questions and be honest with yourself. I hope this helps, even a little!
Brenda : )~
It is going to be a very personal choice, one that only you can make. My situation, I have been obese all my life, my boyfriend the same. We both arrived at the same conclusion: We cannot do it on our own.
For me, I have reasons for opting for surgery that combines malabsorption with restriction, Roux en Y. My boyfriend seems to be more in need of just restriction - and the Sleeve is restriction without a foreign body involved.
You have to look at how your body works - how efficient it is - as in, how does your body use & store calories. Having hypothyroidism, I grew up with a low metabolic rate (temperature, heart rate, blood pressure) and the way my body processes waste (poo). My boyfriend is very active, but eats too much for his output. I look at it like a mathematical problem, so that is how I came to MY conclusion.
My boyfriend does not want to have his bowel changed, he does not want the dietary issues involved in having RNY, and Banding isn't (in his opinion) enough. VSG simplified is like a permanent band that does not involve the fills needed to reach the same goal. He did not set out with VSG as an option, but when he found out about it, it made sense in his case.
We both belong to support groups that include folks who have had RNY, Band, VSG, DS and even at least one person with a Revision. It isn't always apparent why one surgery would be a better fit, so ask LOTS of questions and be honest with yourself. I hope this helps, even a little!
Brenda : )~
Thank you Brenda. Your answer was very helpful.
Like yourself, I have been overweight since my late teens and my entire extended family (aunts, female cousins, grandmothers, mother, sister, brother, uncles and father) are very obese. We all have low metabolism and the female cousins have Stein-Leventhal Syndrome.
My only sister (13 months younger than me) died of a massive stoke when she was 36. She was obese since a very young teen. I gained 100 lbs the year after Elaine died and was never able to lose it. That was 1992.
5 years ago, I developed degenerative disc disease and blew out 4 disc. I had to have major back surgery and was left paralyzed from the waist down for several weeks. Lucky for me, all my feeling came back except the major nerve that runs to the left big toe. I fall very easily and have major leg cramps after too much exercise so I am slow and deliberate. Since I had the back surgery, I have put on another 60 lbs. With out being able to lose some weight so I can start exercising again, I will just keep gaining and gaining.
So knowing that the RNY is helpful with metabolic issues, I understand that I am on the right track with chosing this as my surgery of choice. I need help controlling my metabolic issue as well as my intake issue. Now, when I go in next Tues. to talk with my surgeon, at least I feel like I have an idea of what I want to talk about.
Thanks
Jac
Like yourself, I have been overweight since my late teens and my entire extended family (aunts, female cousins, grandmothers, mother, sister, brother, uncles and father) are very obese. We all have low metabolism and the female cousins have Stein-Leventhal Syndrome.
My only sister (13 months younger than me) died of a massive stoke when she was 36. She was obese since a very young teen. I gained 100 lbs the year after Elaine died and was never able to lose it. That was 1992.
5 years ago, I developed degenerative disc disease and blew out 4 disc. I had to have major back surgery and was left paralyzed from the waist down for several weeks. Lucky for me, all my feeling came back except the major nerve that runs to the left big toe. I fall very easily and have major leg cramps after too much exercise so I am slow and deliberate. Since I had the back surgery, I have put on another 60 lbs. With out being able to lose some weight so I can start exercising again, I will just keep gaining and gaining.
So knowing that the RNY is helpful with metabolic issues, I understand that I am on the right track with chosing this as my surgery of choice. I need help controlling my metabolic issue as well as my intake issue. Now, when I go in next Tues. to talk with my surgeon, at least I feel like I have an idea of what I want to talk about.
Thanks
Jac
PCOS ( Stein-Leventhal Syndrome ) is very common is obese women, so I usually ask the question: Does PCOS happen because of Obesity or is Obesity caused by PCOS? Hearing PCOS ( which I have ) causes fertility issues -- ummm, I had such fertility I even had a tubal pregnancy AFTER having tubal ligation -- I guess my body wanted to make a lot more kids!
Be sure you have metabolic issues - for me I have Hypothyroidism, a carrier of Hemochromatosis ( too much iron in the blood ), and Pernicious Anemia ( commonly caused by autoimmune disease - the digestive tract cannot process B12 ). Many tell-tale signs of metabolic issues include low body temperature, low blood pressure, and processing waste is greatly diminished ( I have a bowel movement usually every other or third day ). Just because you are obese doesn't automatically mean you have metabolic issues. Imagine never sweating - that is me.
In my family, I am blessed with longevity & OBESITY, ha ha! Some of the genetic doo-doo I deal with actually goes back to my decedents having superior survival traits. Great for famine, crappy for modern day availability of food!!! Activity was the only thing keeping me in the upper 200 range, then I blew out my leg - tada, I am now in the low 400 range. Sadly, I am forced to work out five days a week, and I just am not losing weight like I did a decade ago ( don't we all love aging?!? )
With the disc issues, you may be steered more in the RNY direction. Exercise for you has got to be pretty painful! If you are not already doing water workouts, you may want to look into local programs. I swim laps, it gives me solitude & a low stress workout ( I have arthritis, now - waaa! ). Talk long with your surgeon - and maybe even your primary care physician, as he or she has history with you & knows your body. My current doc & I are on the same page, and she gave me a great compliment -- "90 percent who get Gastric Bypass have difficulty staying compliant, ( I ) fall in the ten percent that succeed by following direction." It is a BIG lifestyle change, which also needs to be mental as well as physical. I have 17 friends ( not people I know through support groups ) who have gone through WLS, so I have seen how people can succeed, fail, or just go completely overboard causing physical harm to themselves.
Educate yourself, you will be having to do supplements for life as well as changing how you get nutrition. Prepare yourself - physically & mentally. Find support - friends, family, and groups. LOVE YOURSELF! This is pretty basic stuff, but if you follow the steps, you should be fine. HUGS to you! You will be fine, you are doing the right thing by asking questions. Oh, and the best advice I know: WLS is a tool, and every tool needs to be used correctly. Surgery will not fix everything, but it is going to give you the help to succeed.
Brenda : )~
Be sure you have metabolic issues - for me I have Hypothyroidism, a carrier of Hemochromatosis ( too much iron in the blood ), and Pernicious Anemia ( commonly caused by autoimmune disease - the digestive tract cannot process B12 ). Many tell-tale signs of metabolic issues include low body temperature, low blood pressure, and processing waste is greatly diminished ( I have a bowel movement usually every other or third day ). Just because you are obese doesn't automatically mean you have metabolic issues. Imagine never sweating - that is me.
In my family, I am blessed with longevity & OBESITY, ha ha! Some of the genetic doo-doo I deal with actually goes back to my decedents having superior survival traits. Great for famine, crappy for modern day availability of food!!! Activity was the only thing keeping me in the upper 200 range, then I blew out my leg - tada, I am now in the low 400 range. Sadly, I am forced to work out five days a week, and I just am not losing weight like I did a decade ago ( don't we all love aging?!? )
With the disc issues, you may be steered more in the RNY direction. Exercise for you has got to be pretty painful! If you are not already doing water workouts, you may want to look into local programs. I swim laps, it gives me solitude & a low stress workout ( I have arthritis, now - waaa! ). Talk long with your surgeon - and maybe even your primary care physician, as he or she has history with you & knows your body. My current doc & I are on the same page, and she gave me a great compliment -- "90 percent who get Gastric Bypass have difficulty staying compliant, ( I ) fall in the ten percent that succeed by following direction." It is a BIG lifestyle change, which also needs to be mental as well as physical. I have 17 friends ( not people I know through support groups ) who have gone through WLS, so I have seen how people can succeed, fail, or just go completely overboard causing physical harm to themselves.
Educate yourself, you will be having to do supplements for life as well as changing how you get nutrition. Prepare yourself - physically & mentally. Find support - friends, family, and groups. LOVE YOURSELF! This is pretty basic stuff, but if you follow the steps, you should be fine. HUGS to you! You will be fine, you are doing the right thing by asking questions. Oh, and the best advice I know: WLS is a tool, and every tool needs to be used correctly. Surgery will not fix everything, but it is going to give you the help to succeed.
Brenda : )~
Please research ALL of your options before deciding on a surgery. In people with BMI's over 55 the stats show the most successful surgery to be the Duodenal Switch. It has a sleeve as the stomach but also malabsorbtion (more than the RNY). Know, that if the surgeon you're seeing on Tuesday doesn't do the DS - he will likely tell you bad things about it - most of which aren't true. Do some research before you go to see him. Start with dsfacts.com and also check out the DS board here on OH.
Good luck with whatever decision you make!
Good luck with whatever decision you make!
Cheri I
the DS!
I had the Duodenal Switch! Do yourself a favour and check out www.dsfacts.com - especially if your BMI is over 50!
HW: 426/SW: 421/CW: 165/ GW: 150 Current BMI is 26.6!
the DS!I had the Duodenal Switch! Do yourself a favour and check out www.dsfacts.com - especially if your BMI is over 50!
HW: 426/SW: 421/CW: 165/ GW: 150 Current BMI is 26.6!
Thanks Cheri,
I did check out the DS web site you directed me to. I like what it had to say about patients choosing between the "dumping" with RNY or "malabsorption" with DS. All along my concern has been the throwing up potential with these surgeries.
I noticed right away that the DS indications were vomiting was not an issue for most pts. Since I will have to be on supplements for life regardless of which choice I make, I have absolutely no doubt that I would much rather deal with the "malabsorption" than the "dumping". I checked out my surgeon's web site last night and he does do the DS.
I have received approval for the RNY from BCBS so that may be an issue. But when I have my surgery consult with him on Tues., I intend to discuss the DS as my first choice with the RNY as second. I definitely want the laproscopic surgery so that also may turn out to be an issue as I noticed that the DS sometimes has to be done with open surgery. I don't want to be off work for an extended period of time or end up with a huge scar.
I thank you very much for sharing your thoughts. It was very helpful. I was just drowning in all these different options and had no idea which way to go with the info I had.
Thanks again
Jacque
I did check out the DS web site you directed me to. I like what it had to say about patients choosing between the "dumping" with RNY or "malabsorption" with DS. All along my concern has been the throwing up potential with these surgeries.
I noticed right away that the DS indications were vomiting was not an issue for most pts. Since I will have to be on supplements for life regardless of which choice I make, I have absolutely no doubt that I would much rather deal with the "malabsorption" than the "dumping". I checked out my surgeon's web site last night and he does do the DS.
I have received approval for the RNY from BCBS so that may be an issue. But when I have my surgery consult with him on Tues., I intend to discuss the DS as my first choice with the RNY as second. I definitely want the laproscopic surgery so that also may turn out to be an issue as I noticed that the DS sometimes has to be done with open surgery. I don't want to be off work for an extended period of time or end up with a huge scar.
I thank you very much for sharing your thoughts. It was very helpful. I was just drowning in all these different options and had no idea which way to go with the info I had.
Thanks again
Jacque
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