Approved for surgery, but worth the risk?

Hello. I was part of OH back in 2005 when I had a lapband placed but haven't been on in a long time, as I was doing well. I had 10 years of success with the lapband before having to have it removed in 2015 bc it slipped. A 40 pound weight gain ensured, along with development of diabetes (on 3 meds, including insulin, metformin and Victoza), gastric reflux, fatty liver, high cholesterol. My BMI is (only) 29. I have been able to get approval for a gastrojejunostomy (A roux-en-Y) because of the severe reflux and hiatal hernia complicating the prior surgery. I'm listed for surgery in 6 weeks.

I was excited and really wanted this - my mother died of complications from obesity and diabetes at a relatively young age, and I see this as a possible cure for mine (there are some very positive studies showing resolution of diabetes in low BMI patients with RnY surgery). My goal is to live longer and be more healthy.

But now I'm getting scared. I'm worried about losing too much weight and looking sick. Losing my hair. Giving up the foods I enjoy (and I don't just mean sugars/carbs), dumping syndrome, diarrhea. I haven't told any friends or anyone at work I'm planning to have the surgery for fear that they will judge me for doing it with such a low BMI.

Based on your experiences with RnY surgery, are my fears excessive/ misplaced? Do you think that I would be making a mistake to proceed?

I would really appreciate the perspective of someone who has been through this.

Thank you .

The average weight loss with a revision is 20 pounds, and that is partly from the pre-op liquid diet. That will put you at about 25% BMI, which is not too skinny. You can easily gain that back if you want to.

Diarrhea is not common after RNY, but constipation can be. Many of us have to take stool softeners, fiber, and/or Miralax to relieve the constipation.

If you have hair loss, that is temporary and it grows back in a few months.

There is a good chance, about 75%, that your diabetes will resolve immediately after RNY and you will go home without any of the medicines you are taking for it.

You have almost 100% guarantee that the GERD will resolve and 75% that the diabetes will resolve.

It is a great opportunity, don't make the mistake of not getting the RNY.

Thank you SO much for your thoughtful and informed reply. It really helped.

To address your fears, one by one:

• Revision patients generally do not lose as much weight as folks who have their first surgery. Once you're healed up, you can eat a maintenance level of calories to prevent yourself from losing weight.
  
  
• Hair loss is temporary, and it grows back. Compare this minor, temporary down-side to the lifelong risks of uncontrolled diabetes!
  
  
• Dumping only happens to about 20 - 30% of RNY patients. It happens when you eat foods (sugar) that you really shouldn't be eating in the first place.
  
  
• I have not heard from any RNY'ers in the past six years on OH who have had uncontrolled diarrhea. I had a little bit of trouble the first week post op, but nothing since, and I think that's pretty typical.

Thank you! What a wonderful resource this site is! I really appreciate the information and perspective.

I came back to obesity help for support as I started to experience regain myself. You've been here a long time. I had the rny myself and I can tell you that the only times I have issues with loose stools is if I eat too much fat or sugar. As long as I steer clear of those, I am ok. I also will have it if I eat too much, so I am back to measuring my foods. Don't be so worried about the diarrhea as long as you are watching what you are eating you will be fine. I lost some of my hair about 6 mos to 1 yr post op, but once I got my vitamins in it was better. Dumping does suck, but we can control that as long as we are compliant with the post op diet.

Wishing you the best on your surgery.

Thank you very much. You guys are awesome.

I'd just like to second what those before me have said.

With your family history, weight gain, and current medical conditions/medications, it seems to me that RnY is well worth the risk. Those issues are not likely to resolve on their own, are they?

I chose RnY precisely because I knew I needed the negative physical feedback in addition to the "head work" if I wanted to lose the weight and keep it off. RnY offered the best chance and most researched longterm successes when I had my surgery.

Seven years out, the temporary hair loss and uncomfortable sensations when I eat too much/eat the wrong things were and ARE completely worth it. I did have a rebound weight gain of 20 pounds (up to 25 on a bad day) but I lost it once I became compliant again with a protein heavy diet. Prior to surgery, that wouldn't have happened.

Worry not about what your friends or work colleagues think. Most of them do not have your history.

I wish you the best!

Thank you. To hear that it worked for you, that your quality of life is good and that you are happy with your decision is very very helpful. I am glad that you are doing well. You are certainly right about lining up the reasons to do it. They are valid.

I was approved for RNY with a lower BMI because of the comorbity of diabetes . This resolved immediately after surgery and I haven't needed a diabetic drug since ( in nine years )

I have never had a loose stool issue except right after surgery when I came home once I spoiled my pajamas ... that's it . My fiancé tells me I can fart in my sleep and occasionally peel wallpaper ... like HE doesn't lol !

I think my digestion is exactly like a normal semi - vegetarians' ... I gotta watch how much kale and beans I eat before getting on a flight ... but who doesn't think about these things ? I know I did well before surgery .

As far as absorbing vitamins and fat malabsorption go ... you will have to take daily vitamins for sure for life . Then again ... wouldn't a normie do the same thing since it's been proven daily vitamins extend life and improve the quality of life dramatically ?

I still retain some fat malabsorption nine years post op which really comes in handy when I can't resist a party food or fatty catered buffet item .I'm SO glad I chose the RNY . ((()))) good luck