Unsure... Roux-en-y??? Sleeve???

[delianasmummy]

This is tough for you, i had my appointment yesterday and i was talking to the nurse in regards to my choice of surgery, i have decided against the band and the bypass would prefer the sleeve, but the nurse said to me that the surgeon will always try and get you to take the bypass for 2 main reasons 1 being you won't be back for it to be corrected like the band and sleeve and 2 it looks good on him how many bypass's he has performed, i was shocked to hear that.

[accordingtome]

This is tough for you, i had my appointment yesterday and i was talking to the nurse in regards to my choice of surgery, i have decided against the band and the bypass would prefer the sleeve, but the nurse said to me that the surgeon will always try and get you to take the bypass for 2 main reasons 1 being you won't be back for it to be corrected like the band and sleeve and 2 it looks good on him how many bypass's he has performed, i was shocked to hear that.

I was wondering, do you know what kind of corrections have to be done with the sleeve? I've never heard of that and am just curious. I don't think I've heard anything good about the band. I initially wanted one and am so glad that I went with the sleeve. I have three friends who have had the gastric bypass and they are all good with it.

[Janese58]

The sleeve is just so cut (no pun intended) and dried. I too didnt like the idea of messing with the re routeing of my insides. Taking out 85% of my stomach making it nearly impossible for me to pig out for the rest of my life but still enjoy a sweet every now and then was a no brainer. I didnt want any restrictions on what I ate for life, just how much.

[connie]

In all of the searching and reading that I have done I have not heard of one single CORRECTION on the sleeve---I think the nurse might have got the rerouting one mixed up with the sleeve. I do know personally people that have had the band and had trouble and those that had the RNY (the one that reroutes everything), and BOTH of those surgeries have had some serious issues. AND that could be because the person did not follow directions!!! Now, that is not to say sleeve can too---I mean, I could get run over by a car when I cross the street also. BUT I believe that I did read that someone had to have their throat, or tube or stomach or something kinda stretched because apparently they could not get anything down. I DO NOT KNOW THIS FOR A FACT---but I think I did read that.

[tcady]

You probably already had your surgery but for future readers - have the bypass! I had the sleeve and am not loosing much at all. It is way too easy to eat junk food still. I can only eat a little at a time but it is not magic, I have to diet and exercise HARD to loose a few lbs a month and if I don/t the only consequence is I dont loose. I would much rather have suffered the dumping syndrome I so feared in order to control my bad eating habits better. The sleeve is the easy way out. We think"With the sleeve we can still eat whatever we want" - well yeah - and we make bad food choices now so why will we change after the sleeve?
It is hard. I am mad I spent $5000 on it and now may have to spend even more and have surgery again to have a revision to the bypass so I can REALLY loose weight.

I think it is partly my Dr didnt make my stomach small enough, and partly that it is just too hard for me to control what I eat. The sleeve helps control how much I eat, and I do like that part of it but I cant make myself stop eating CRAP food.

Hopefully with the bypass I would have dumping syndrome to deter me, and if I did at some bad choices they would not be absorbed totally too.

[tcady]

Oh yeah - for those above asking what it means by corrections - they meant revisions. Meaning the person isnt loosing weight with the band or the sleeve so goes back to get the bypass in order to finally loose the weight for good. It is the most successful surgery as far as how much people loose and how long they keep it off. Because of smaller pouch and malabsorption. I am considering revision form sleeve to bypass because I am not loosing, too easy to cheat the sleeve. If you cant control what you eat now, why think you can do so with a sleeve? Yeah I eat less but if I put high cal food in my mouth, even just a 1/2 a cup at a time, and I do that several times a day, I wont loose.

[N2DVN]

What works for one person may not work for the other. Don't let anyone make this decision for you. It's your life and your health. You need to research and figure out what will work best for you. There are several factors to consider before selecting which WLS you select. If you are disciplined enough to follow the guidelines, the sleeve can be a great tool to assist you with your weightloss.

In no way do I want the bypass. The dumping and malnutrition are not worth it to me. I want to still be able to at least taste something w/o the fear that I am going to be sick. After dealing w/a spastic colon during my first marriage, I do not want to get sick every time I possibly eat something wrong.

[Kylady1975]

Here is my thought. It doesn't matter what surgery you have if your not going to stop eating all the junk food your not going to loose the weight. I have a friend that had the bypass and she is bigger then ever. Yes she lost her weight but not everyone dumps and most can eat sugar and garbage with the bypass. I personally think it is whatever the patiant and doc thinks would be best. I say that to say this you know yourself and body better than anyone. Me If i wanted a bite of fudge at christmas I didn';t want to get sick. I also in todays economy don't want to risk not having money for vitamens that you have to have for the rest of your life from bypass. I do however think it is unfair to blame the sleeve for you not loosing weight when you admitt your eating unhealthy garbage all the time. As we are told its a tool. I am just 2 weeks out and I know already its not a miracle but I have faith if I listen to my doc and nut I will loose the weight. Ok Im done venting.. Sorry

[Grace]

Oh yeah - for those above asking what it means by corrections - they meant revisions. Meaning the person isnt loosing weight with the band or the sleeve so goes back to get the bypass in order to finally loose the weight for good. It is the most successful surgery as far as how much people loose and how long they keep it off. Because of smaller pouch and malabsorption. I am considering revision form sleeve to bypass because I am not loosing, too easy to cheat the sleeve. If you cant control what you eat now, why think you can do so with a sleeve? Yeah I eat less but if I put high cal food in my mouth, even just a 1/2 a cup at a time, and I do that several times a day, I wont loose.

If a person does not feel they are ready to make a lifelong commitment to eating well for their health, meaning low sugar and very limited junk forever... they simply aren't ready for any bariatric surgery. Even the rny isn't magic. My niece had it and has not much dumping at all, only fats bother her. She is losing weight at about the same rate I am (about 10 lbs a month) but she is eating breads and such and not as much protein as she should. She would probably lose faster than I am if she ate as directed or had more dumping. Luckily for her, the cravings for sweets went away after surgery, but then, so did mine with the sleeve. Since she is a mini-me in looks I'm thinking it's partly genetics and not a function of the surgery whether you still crave sugars or not.
There are no miracles here. Just a chance to help ourselves get and stay healthy. We still have to think before we eat. We still have to journal, weigh our food, drink lots of clean liquids, and get some exercise. Mostly we need to realize before hand that whether it's rny or sleeve, we need to have the mindset to be determined to do this thing and change our eating habits forever... or we should just realize we aren't ready yet.
In short, you can't rely on the dumping from rny to modify your behavior. Some have it, some don't. That's an awfully big chance to take, especially since even in those who dump, it does go away after about a year or so... then what?
This is one reason most weight loss centers of excellence insist their patients lose weight on their own before they schedule surgery.
It's part of the process to getting where one needs to be mentally to prepare for the hard work and change required to be successful after surgery.

As far as malabsorption is concerned, it's a personal choice to trade off any future issues due to possibly not getting nutrients... with faster and more weight loss. The rny weight drop is about 10-15% more than the sleeve on average. If getting down to thin is the aim, then it's a consideration worth thinking about. If (like me) one has other illnesses that require optimum nutrition and (like me) one does not care to be very thin or even near "normal" weight according to the charts, then the sleeve is the ticket. My start weight was 335. According to the almighty insurance charts that meant I needed to lose (hahahaha) 200 lbs to get to 135. I have zero interest in weighing 135 lbs, or even 155 lbs. My goal weight is 185, perhaps 180 to qualify for cheaper life insurance but that would be the only reason why. So, at 185 I will have dropped 75% of my excess weight. I'm perfectly fine with that. My niece wants to be 155(same height) so she chose the rny to get the extra push. It will be interesting to see how it plays out for each of us.

I'm sorry to hear you aren't having the success you imagined with the sleeve. I don't know how long ago you had it, you don't show a ticker or a surgery date...but if it's been quite a while and you feel the rny might be better for you, perhaps you can get your doc to agree. I wish you luck and hope whatever your decision it brings you peace.

There are a lot of considerations other than which surgery will make it less easy to cheat.


Update on this post, 14 months later, because it happened to pop up.
Niece and I ended up at nearly exactly the same weight, as did her twin who had the lap band.
Talk about family genetic set points! Just reinforces in my head that genetics play a bigger role in this than which surgery, though I do think the sleeve is better for those with any other stomach or nutrition issues...otherwise I am not convinced it makes a difference 2 yrs out...and I would still never choose the band, but that's personal ick about the device inside me issues.

[catherine-lynn]

im kinda in the same boat with you, I have been reading up on both surgeries and talking people that have had either of them done. I came to think both are risky both have their benefit and both are covered by my insurance its just personal preference of what is better for you. I want the sleeve because i need less stomach and they dont touch the small intestine and they dont leave you unuseable stomach just sitting there. they remove it. I want to loose weight slowly and healthy and I also want to be able to take pills for cramps or headache when need be. rny is very picky.

[Stratusphr]

Only YOU can make this decision. Listen to what you doctor says but still go with your gut. No pun intended! I do have to clarify something, the sleeve is NOTHING like the duodenal switch. Some times the sleeve is the FIRST step morbidly obese folks go through and then follow up with the DS. The DS is the big boy of ALL the WLS procedures, and it is also the one with the least absorption. I can only tell you what I know and that is the sleeve was the right choice for me. I never considered RNY, but I DID consider the sleeve. Thank the Good Lord I knew enough people who'd had it, I ruled it out. I needed the forced portion control, I hear people say it isn't reversible.....and I'd say, "and your point is?" I wasn't looking for something temporary, this isn't WW or Medifast, where there is an end time. After 30 years of yo yo dieting, I know this is forever. I'm not going to lose weight and be "cured". This is a life long commitment. The doctor did his job and the rest is up to me. I can advise you to ask questions and ask around. Here in the little east TX town we lived in for 20 years....WLS is practically a status symbol - I know five people who've been banded. 2 have had them removed, one six weeks after she got it, one after three years. She lost weight and regained all of it and then started having problems with it. 2 lost and have regained most of what they lost and one has been very successful. Sleeve - almost everyone I know at all four support groups, have had sleeve surgery and the majority of them are doing very well. I'm over three years out, reached goal in six months. I've been maintaining for 2.5 years. RNY - there are numerous, a few I know well and some are friends of friends......I only know two who have been successful long term. The others vary. Most never reached goal, all but those two have regained a portion of their weight back, a couple have gained all of their weight back and want to have another surgery to 'tighten' everything up. So, there you have it. RNY is still considered the gold standard for WLS, but I think in the future, VSG will move into that spot. That is in my humble opinion. I'd suggest attending area support groups and asking questions of real live patients!!! Seems like sleeve surgery is very popular here in Dallas, and I know ALL of the patients that attend are either on much less diabetes medication, or are off all of it totally!!!

As we've all said, you need to do a lot of research and make your own decision!!! Good luck!

[Yankeebaker]

Hey - if there's a military treatment facility with a bariatric team nearby, see if you can go there. They DO offer the sleeve at some MTFs even though Tricare doesn't cover it. I just learned this today by readying other military spouses post that they had the sleeve done at an MTF. Best of luck to you!

[Steve Webb]

Others here are right for the most part. TCady I don't fully agree with. She has lost 95 pounds that is pretty good. Also, I also know someone that had the full gastric and is gaining her weight back because she once again started drinking carbonated soda's. If you live like the Doctors and NUT's tell you too you will lose all the excess weight and keep it off and be healthier. I won't have the full gastric because I already have issues with absorbing calcium and magnesium. I know the sleeve is my best option. I am going to request the Doctor use the smallest Boogie on me. ( The boogie is the device they put down your throat into the stomach during surgery to guide the Surgeon in making the sleeve.) The boogies come in differant sizes. I want a size 28-32 boogie. I hope the Surgeon will grant my wish on this. Best wishes in whatever decision you make.

[bamagir1]

My surgeon who is at UAB in birmingham is very knowageable on all the surguries. He also will not tell which one to do but tells you the ups and downs of all of them. The hormone which is gherin (sp?) is what controls hunger. Studies show that both the bypass and sleeve are about the same for both. As far as being a diabectic, which I am also, is also about the same over the long term. Losing weight in and of inself will almost always change you insulin levels. I was considering the by-pass until I did all the research and found that there is no difference in the stats at year 2. Losing may or may not be a little slower but the risk and long term effects I am choosing the sleeve. I hope this helps. Good luck with whatever you choose.

[Kimpossible318]

I originally wanted to do gastric bypass because a friend of mine had it done earlier this year and because I had never heard of the sleeve before. My surgeon told me he would recommend me for either bypass or sleeve - so it was my choice (my starting weight was 347, but I am not diabetic). I scheduled my date and all that jazz and then started feeling really uncomfortable for some reason with the redirection of my organs so I decided to research the sleeve. The more I researched, the more I felt confident this would be the right procedure for me. I came up with a list of questions and made another appointment with my doctor to ask before I made my final decision. As he put it - it's totally up to me, but the reason he prefers the sleeve over bypass or even the lap band is because it is sort of the more natural of the 3. With the band, you are putting something foreign in the body. With the bypass you are rerouting things as nature had intended. With the sleeve, everything remains as is, but just the stomach is made to be smaller. That sealed the deal for me and I'm not almost 3 weeks post-op with the sleeve.

Best wishes to you for making the right decision for you! =)