Decision made

Hi guys, I am new here, saw a bariatric surgeon 2 weeks ago, he gave me two options to consider, Gastric band or sleeve gastrectomy.  He said that due to my health concerns, severe badly controlled rheumatoid arthritis, fibromyalgia, osteoarthritis, sleep apnoea and others (sorry), the sleeve would definitely be an option as the GB may need lots of fiddling around and more appointments travelling as hes 2.5 hours away at least, and my mobility gives me lots of hassle and pain.  Anyhow I have decide on the band as I am too scared to have my stomach partially removed with all the tablets I take ulcers are a very real concern.  He said I will be able to continue all my meds with the band too, but no antiinflammatories with the sleeve, that is something I cannot promise as my GP said I have a severe condition and it needs medications from time to time that he won't allow.

Anyway I am going to see surgeon tomorrow and he is getting me to sign a consent form.  I am nervous esp as I am not a big big eater and a lot of my weight gain can be contributed to immobility and steroids and 3 other weight gain meds, but I have to do this to give it a try, please wish me luck.  I don't know much about what to expect after surgery yet so any advice is welcome.  I know I will be on milkshakes for approx 2 weeks and he said multivitamins for a month.  I already can't absorb iron orally and have to have infusions so my GP said this is another reason not to do sleeve as it will affect absorption of other nutrients.  Thanks for any input.  Jane.

I have a band and love it but i am slightly concerned about two things your GP told you. I was under the impression that one of the reasons for having a sleeve is that you CAN take anti-inflammatories and I know that there is no malabsorption with the sleeve so am not sure why having a sleeve would have any more effect on absorption than having a band.

You should also be aware that some bandsters ( I am one of them) cannot swallow any tablets, however small. They all need to be crushed or dissolved. This is not necessarily insuperable but if you take time-release meds coudl be an issue.

Also if you are not a big eater, i am not sure how much the band (or the sleeve) will help you.

And multi vits are for life after the band, not just a month!

Sorry to sound negative but I feel that you need to double check some of the info you have been given. But I am not sleeved and it may be that i am wrong in what I have said!

Kate

HI Kate, thanks for replying, I have read some info on both prodeures and I have definitely read that some of the malabsorption happens with the sleeve, and he did mention it but I will double check, thankyou.  As for the tablets I specifically asked him and he said most people have no probs and my GP said if I had to have my painkillers via liquid form then so be it, but again I will check.  I also read that multi vits are for life but he def said only a month?  I will double check that too.  Many thanks, well done for your weight loss, amazing!  I hope I can get to my goal.  I need to lose 35 -40kg, do I put the little charts up on here when I have had the surgery?  He said he could do my op within 6 weeks and that was 2 weeks ago, it is costing a bit but I think it will be well worth it. My drs want me to have the op for associated comorbidities that are creeping up and diabetes is next.  I know I am already high risk for ulcers and have endoscopies yearly because of it, he said because of this I can only take antiinflammatories if absolutely necessary and def not with the sleeve as there is so little of the tummy left?  Thanks again Kate.

 
The only thing that sleeves malabsorb is B12 and that only happens in less than 1% of the sleeved population.  We do not malabsorb vitamins. I really think you are confusing bypass with a sleeve.

Nooooo, ALL WLS folks need a multivitamin twice daily due to limited food consumption.

If you have a band the diameter of the pass  through from your upper to lower stomach is about the diameter of a thermometer.  Are all the pills you refer to that small?  If not, can you get them all in liquids?

If not, you might want to consider the sleeve as your surgeon suggested.

No, what you are referring to is bypass.  Bypass is the ONLY surgery type that NSAIDs are a no go. NSAIDs are absolutely fine with sleeves, just not bypass.

It used to be thought that NSAIDs caused erosion in bands, that has since been proven to be incorrect.  Although some surgeons still don't want their banded people taking them.  I'm not really sure why.

If you are at high risk for ulcers the sleeve is for you.  We have less risk with ulcers because the portion of the stomach removed is where ulcers typically happen.

My reaction to your post is the same as Kate's. This is the first time I ever heard about malabsorption with the sleeve. Since the sleeve leaves the instestines intact, I just don't see how it would cause malabsorption. If you tend to get ulcers, anti-inflammatories are already a problem for you, but I don't know if the sleeve would make that better or worse. Why don't you post this on the sleeve forum? They'll probably try to persuade you that the band is the work of the devil and/or a complete waste of money, but surely they'll be able to answer your questions about malabsorption, medication, and vitamin supplementation.

Good luck.

Jean

 
No, NSAIDs do not require a stomach to be absorbed.  That's why we can take NSAIDs via SL or IV, not just orally.

Definitely misinformation on malabsorption, and the NSAID usage. Many and I mean 1000's of appeals are won for VSG because of the need for use of steroids and NSAIDs. As Carmelita pointed out, there is zero malabsorption with VSG, but we do need to supplement with good quality adult vitamins because we eat such small portions. However, you can do more research at this link, and I agree with "Think twice, cut once".

Tons of information on VSG: Personal discussions along with dietary/nutritional/vitamin guidelines along with research studies with many key points of interest.

http://vsgfaq.wordpress.com/

I had the band first, and now the sleeve. They are night and day, and if you want more information on my personal experiences on both sides, feel free to shoot me a message or add me as a friend.

If I were you I wouldnt make any rush decisions and would thoroughly research both procedures before committing to one. This is your body, the only one you get, and you need the whole story to make an informed decision.

I would also consider seeing another surgeon who actually knows about the procedure he is performing!!!

Please spend some time on both boards, lap band and vsg and do your research. I am thankful I did because I was originally only offered lap band, told it was "perfect" for me- after doing research I realized that is not the case for me and switched. I am thankful every day for making an informed decision that is best for me.

Not trying to band bash by any means, there is a right procedure for everyone out there, but the assumption that the band is safer than VSG is not correct from the research I have done, especially after the insertion of the band.
Research is vital.

I wish you luck with whatever tool you decide to choose.

Jean M. asked me to respond to you, as I have had the sleeve.  I too live 2 hours from the bariatric center, which is the reason I decided on the sleeve.  For me, the after care was going to be a burden.

Your GP is incorrect in regard to absorbtion.  We sleevies DO absorb all nutrients, just like you do with the lap band.  The gastric bypass and DS are the mal-absorption surgeries that you would want to avoid.   Sleevies eat and digest food just the same way as before surgery.  Our stomachs are just smaller so that we cannot eat as much.  Our intestines are NOT re-routed like gastric bypass.  Most GPs have never heard of the sleeve and I'm always hearing "Gastric Bypass" from them.  Even if I correct them, they don't seem interested in what I have to say.  I would suggest you talk to the surgeon (who's the expert) about all of these medication questions.

You do have to take some supplements (even with the lapband) because you can't eat enough to give yourself enough nutrients.  I take 2 multivitamins, B complex and calcium daily and B-12 once a week. 

Surgeons differ on whether you can take NSAIDS with the sleeve.  Some say they are ok, others say no..  Mine says he would rather I didn't but if I truly needed them, I could.  Since surgery, I haven't had to take NSAIDS as my knee pain disappeared.  (YAY!)  I did have to take them when I had a gout flare up, but I took them with Omeprozole and had no problem at all. 

Whatever you decide, it's a personal choice.  If you aren't comfortable with the sleeve, then I would go with the band.   I certainly don't regret my decision to go with the sleeve.  I've lost 133 pounds in a little less than a year!

Good luck!