Anyone had a sleeve to RNY?

Good morning!

I'm almost postivite I'm going with a sleeve, for many reasons...but I'm wondering if anyone out there went with  a sleeve and then eventually converted to a RNY? Would love to hear from you if you did....

Cheers,
Joan

No personal esperience here, but---should you find that you need malabsorption, the logic choice for revision would be to the DS. Your stomach wouldn't be cut on again, just the 'switch' part done on your small intestine. There are a whole host of problems associate with the RNY pouch that simply don't happen with the Sleeve or the DS.

 The sleeve is the first part of the DS surgery.   The ONLY people I have ever read about who have gotten "revised" from sleeve to RNY are those whose surgeons don't do the DS (because they never learned how and, if they can convince unsuspecting patients that the RNY is "good enough" for them, never will).   

If you need the malabsorption of a bypass, the DS bypass is the way to go, plus you will already be halfway there with your sleeve stomach.    FYI, if you are not a WLS lightweight, the DS might be the way to go for your first surgery as there is a synergistic effect of having both the sleeve and intestinal bypass done at the same time - you lose more weight initially and keep it off for a longer time.   It's especially helpful for those who find it difficult to adhere to the lifestyle changes recommended for patients after WLS surgery.  It changes the metabolism to help in keeping the "bounceback" weight off.

Right now, I've noticed that a lot of RNY doctors are learning to do the sleeve because it is an alternative to the lapband, as it is done laparoscopically and doesn't have the complications which sometimes occur with the band.    The sleeve is an easier surgery to learn than the DS (which involves complicated intestinal hookups), so these same docs will "recommend" revising to the RNY because it's the only bypass they know how to do.  

Ask your surgeon what size "bougie" he is using to make your sleeve.   Many people do not know that sleeves come in different sizes, the choice of which can be customized to fit the individual patient.

Thanks for all your feedback - I really do appreciate it.

This will be my first (and hopefully only) adventure in WLS...and I am not sure I need the malabsorbtion of a RNY, so the sleeve seems to be the way to go. (I'd like to loose 100 pounds, or so...)  I get the benefits of the reduced stomach, without the complications of intestinal rerouting. Particularly when I read that the malabsorbtion of the RNY may only last two years or so...

As for the DS...it sounds pretty scary to me, to tell you the truth. It just seems like there are so many complications and then a lifelong battle with lactose intolerance, awkward bowel issues, deficiencies, etc....if I'm wrong, please someone correct me. I'd love to hear this is good option...especially since I've heard you don't have to give up mayo or cream in your coffee. :-)

Thanks again for the input...

Joan

I had RNY, and I had massive complications. I puked all the time, I had severe iron deficiencies, I was very lactose intolerant and  there were awkward bowel issues. Now that I have the DS I'm actually doing better. I think part of it is because RNY bypasses the duodenum and we need it. They do bypass intestine with the RNY, it's just not done at the same point as it is with the DS.

I love, love, love the DS. There's no lactose in cream, because cream is fat and lactose is sugar, not fat.  I eat bacon, eggs, meat (how I missed meat, since I couldn't keep it down with RNY), pudding (I made sugar free pudding with cream, tastes like a cream puff), and since my revision I'm down over 50 lbs. It's amazing to me.

With the DS, I have a stomach again, albeit a sleeve, so I am still eating the smaller amounts I ate with RNY, but more satisfying food. I can take nsaids again (yay for ibuprofen during that time of the month) and I have none of that damned dumping syndrome. My 25th anniversary is this weekend and you can be sure I'm having some of the cake.

The RNY scared/scares the crap outta me. Pre-op, before I knew about the DS, I was schedule to get the RNY, even though I hated the idea of living with it. Thank the powers that be someone told me about the DS before I went under the knife.

I've been living aith the DS for more than six years now, and it's the most 'normal' life I've ever had. I eat anything I truly want, I have had no food intolerances of ANY kind, and no more 'awkward bowel issues' than I did pre-op. (For example, in the past 6+ years, I've had a BM in a public toilet *maybe* once a year.)

Vitamin deficiencies are a risk with any WLS, even the restriction-only ones (because of the greatly reduced volume of food). Did you know that many obese NON-ops are actually malnourished? It's a really good idea to get your vitamin levels checked BEFORE surgery, so you can work on any deficiencies you may have now.

I do take vitamins/supplements four times a day, but it's completely become such a habit that I don't have to "remember" to do it. I eat, I take pills. Easy-peasy.

 The DS, in many cases, can be easier to live with than the ERNY, which is the extended RNY that people get when they have regain after their original RNY.     The malabsorption and potty problems are actually LESS with the DS.  

What is scaring you is probably the OLD DS/bpd procedure which had a lot of problems.   If you want to know all about the modern DS surgery, go and ask this same question on the DS board.  You'll find the DS people very friendly and informative.   They are sick and tired of RNY doctors turning people off to the DS by scaring them using the side effects of the older surgery which isn't done anymore. 

Believe me when I say that the DS is a helluva lot less scary than the RNY.  I came VERY close to getting a RNY and I just had DS surgery.  I'm still shaking my head over the thought that you'd even consider revising from a sleeve to a RNY - although I realize that it's the product of misinformation.