Paul Dally Bypass or Sleeve????

Hi Paul,
 You responded to my first post on OH. And now you really got me thinking what should I do.I am trying to make the decision wether to have the Bypass or the Sleeve. I didn't realize that you are a bariatric surgeon. I am currently searching for a Doctor. I currently go to OHSU for most of my medical issues. My Cardiologist is there and he and I had spoke about WLS. I had the band in 2004 in Mexico and then removed by Dr. Neil in 2008 due to slippage. I just attended the bariatric orientation at OHSU to see what they had to offer. I had seen Dr Deveney in 2008 and he is the one that told me that my band needed to be removed. Because of lower cost I went to Dr Neil for the removal. I am a self pay so this is a big decision for me. I want to make the right choice. I also have many concerns.
I have a pacemaker that was put in, in 2010. A breast reduction in 2008 that didn't go well. I had some complications after that surgery. I am Pre Diabetic I have high colestrol that is being controled by meds.  So I am very concerned about complications and what kind of impact that can have. And since I am a self pay concern on what that could also end up costing me. I don't want to make the decision based on cost alone but I must give it some thought.
In your post you had advised me to look at the sleeve rather than the bypass. Could you please explain more on that? I would really apreciate it.
Thanks a bunch......

My concerns is that the sleeve is not reversible and the bypass is. If complications arise what can you do if you have the sleeve?

Hi that was me that wrote you not Dr. Dally himself, actually he's off for 6 mos. hiking the Pacific Crest Trail. It's my understanding that the RNY isn't reversible either but I could be wrong. With the sleeve 80 % of the stomach is removed where with the RNY it is left there but is "blind" in the sense that it can't be scoped and then the intestines are reattatched to the smaller stomach. I can see your concern with your other health issues and being self pay. I do know that OHSU is a great institution also. I just have lots of faith in Dr.s Dally and Cagle and know that they wouldn't do a surgery on you if it would cause harm down the road. I can't give you an answer, you have to make the final decision but it's really good that you are investigating things thoroughly. If I can answer anything else just give a shout.

Thanks sorry I got confused. So you have the band and would like to have the sleeve done? I just attended the oreintation at OHSU and it was my understanding that the bypass can be reversed if it was needed for health problems. I also have a few friends that have had the bypass but regained some weight so that's another reason trying to find the right choice is so difficult. I understand with the sleeve that lots of people don't have hunger and that is a real appeal to me. I really appreciate your advise just have to do lots more research I guess until I can decide. I have read so much it all gets so confusing. Thanks again......

That's OK it all gets confusing before surgery, there is such an information overload your brain is on spin cycle sometimes. Yes I have the band but wish I could get the sleeve, I'm just a little more scared of the RNY but lots of folks have had it and it is a good valid surgery. Just keep at it till you feel comfortable with your choice.

I had to go to class in June, so I remember hearing that yes, RNY can be revised, and fixed back to old stomach you had before, but I can't remember the details.

I had lap band on march 2 2010

An RNY ~can~ be reversed , but it is major surgery & it is basically considered irreversable . I was self pay as well . That's rough , but worth it , if you can somehow swing it . I don't know much about the sleeve , so I can't give an opinion . I haven't heard anything negative about it . I had a Medial RNY , which is uncommon . It has a little better success rate than a proximal RNY & has less severe side affects than the Distal RNY . Because of my arthritis , I do wish I had had a surgical option that would have allowed me to take NSAIDS afterwards . You can't take Ibuprophen or other NSAIDS after an RNY . Good luck with making your choice .

Thanks everyone I think I have made up my mind to go with the Divided Roux-en -Y ("roo-en-y") Gastric Bypass. Since my band I have not been able to take any ibuprofen.  My cardiologist also recommends that I don't take it anyway since it can be hard on your heart.  So that is not really something that I am worried about.  I just want this to be more successful than the lapband was. I was happy with my lapband when it worked the sad part is it was very short lived. The bypass seems to be more successful and I have spoke to many very happy people. I realize the sleeve is becomming more and more popular. But for me it just hasn't been done for long enough. So I am gonna go with the golden rule of choice as Dr. Deveney put it.  I want to thank everyone that has helped me to make my decision, it has not been easy..... In the process now of getting all the test I will need done and preparing for the surgery date. I hope I am able to get this done before the end of the year.
Thanks again, I will keep ya posted........Thanks again....

I'm glad you've made a choice that you're comfortable with . That's half the battle .