RANT!!!

About a month ago I went to see my bariatric surgeon. We always spoke about removing my old broken up band and revising me to a sleeve. I've been so afraid of having surgery that I've put it off for years now. This visit, he recommended something I was not prepared for-RnY! I was shocked and devastated! He ALWAYS suggested the sleeve and said he wouldn't recommend RnY based on my weight and eating habits. I asked him why the sudden change, and he stated it was due to my metabolism registering so low on the scale. I was diagnosed with metabolic syndrome way back in 2005, thus the reason for the lap band back then. This surgeon is the same one who did that surgery. Even though he's one of the best, I think deep down I'm bothered by the fact that I was diagnosed with metabolic syndrome back in the day but was discouraged against RnY (a metabolic surgery) and encouraged to have lap-band surgery (a restrictive surgery). Back then, I researched the surgeries but knew nothing about the meaning/difference between metabolic and restrictive surgery. I just didn't get it. Needless to say, I left his office in tears and full of anxiety. RnY has always really frightened me. Not only does the rerouting scare me, but also, the fact that:

• I am anemic
• I am gluten intolerant
• I have diverticulitis
• I need ibuprofen for my severe menstrual cramps and joint pain

Just when I mustered up the courage to finally go to the doc to schedule removal and consider revising to the sleeve, I'm hit with this. Definitely a setback for me. Just wanted to get it out and felt this was THE place for that ?

Any and all comments welcome.

I am sorry you are dealing with all of that. I think I would seek a second opinion.

Unless you have GERD, in which Sleeve is not recommended, I would get what I wanted. Or feel I need. If you think you need metabolic WLS - why not DS?

BTW: I don't have Celiac, but I am very sensitive to grains. Plus dairy. Intolerance/allergies. But I tolerate meat, fish rather well.

Thanks so much! I know he's the professional, but I'm just not sure about what he's recommending. I told him I thought the sleeve was also partly metabolic and he told me it's purely restrictive. I had no idea. He also said his concern with me having sleeve surgery is that 10 years from now, we'd be sitting in his office having a conversation about another revision since the band was unsuccessful. I tried explaining that the band WAS actually successful but it literally broke in 2 places, which is why it stopped working. I think you're right. There's another surgeon not too far from him who I plan on seeing for a second opinion.

With the metabolic problem I would look at the DS.

No one here does the DS. I'm in San Diego. I suppose I can contact Dr Keshishian (spelling?) in Pasadena and see if he takes my insurance and speak to him about my situation. Thanks so much for your input. I need all the help and advice I can get! Also, is there a weight limit for having the DS? I'm 5'4 and 200 pounds.

I think it is up to a doc. Some would not recommend getting DS for someone in low BMI. But if you are determined, then find a really good doc to do it. Like Dr K.

I know a couple of people with lower BMI that got the DS to help them with co-morbilities like diabetes. If you have/had a band that broke, I would personally trust only the best docs to cut me again.

BTW,: now the docs don't recommend that anyone post op any WLS to take NSAIDs. DS, sleeve, RNY. For the last one - the problem is the blind remnant stomach. If ulcers form tere, bleefble, acid may end up in our body cavities. And it could be difficult to diagnose and it can onlyobe fixed in a surgery.

I'd rather get a sleeve. However, I must admit seems that often sleeve patients are being revised to RnY.

Some patients get revised to sleeve when they deal with uncontrolled GERD.

Or regain. But - IMO - only a few regains are due to metabolic issues, most are due to overeating, or eating the wrong foods (carbs, too much, etc)). In the second case - Sleeve or RNY - they would have regained regardless what surgery they had.

Revised to the sleeve or RnY?

oops. Revised Sleeve to RNY due to GERD.

Thanks for catching it