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

[Kristina Lynn Edmonds]

Since May I have been set in having the sleeve. I had done all the research and that good stuff. Knowing that the sleeve is sometimes a first step sometimes followed up by a sleeve revision to Roux-en-y, I was under the assumption that Hey, I'll have the sleeve done and then if it does not work out as I have planned, then I will revise to the Roux-en-y. Well, at my surgeon appointment yesterday I found out that the Navy no longer covers sleeve revisions so I would have to pay out of Pocket. He recommends the Roux-en-y over the sleeve for me because I am Diabetic and my BMI is 47. Now I am confused, for months I have been so set on the sleeve, and now, even though he has told me it is my decision and that he will support it even if I choose the sleeve, his recommendation is for the Roux-en-y, which is also what my endocrinologist recommends. I understand the benefits of the Roux-en-y, but somehow it just seems to be a scary option. I know that I should step back and look at the situation rationally and decide which will be MOST beneficial for me in the long run. Also, I need to remember that they are both SURGERY and there are always the risks and complications that may occur. I just am having a hard time getting around the fact that my insides will be rearranged!?!?! There is not really a question to this post, just a general spill my guts get it off my chest. All of my close supporters I have turned to have said, Yes, the Roux-en-y sounds more beneficial, but its your choice. How am I so scared of the Roux-en-y when the sleeve does not seem so scary? Deep down I KNOW the Roux-en-y would help with my diabetes and be most likely the most beneficial, I just can't seem to wrap my head around it....

[accordingtome]

That's a tough one. There are pro's and con's to both procedures. You are the only one who can make this decision. Research both procedures and decide which one you can live with. The only thing that would make me say go with the bypass is because that is what your Doctor's are recommending. Good Luck.

[Grace]

You'll make the decision that is right for you. Thinking about why the rny re: diabetes. The dumping aspect is about 90% of folks (according to my seminars) for rny but only about 40% for sleeve. I am thinking that your doc wants to be sure you have a whole lot of motivation to not eat sugars. Also isn't there some evidence that rny affects diabetes in a really positive way almost immediately? As all are saying there are Pros and Cons to each. Only you know what you need....

[bobbybeegood]

I would hate to give any one bad advise. I agree with you on the cons of the RnY which is why I didn't go for it. the biggest selling point, for a life time, over the RnY is the removal of the hunger hormone gland. I would think with that alone, would be a huge plus for your long term goal. There is also a duodenal switch, which is similar to a gastric sleeve that dumps into a RnY setup at the bottom of the stomach. You get the benefits of both surgeries. Also, the sleeve is forever & the RnY is reversible back to your old stomach when the time comes. Just food for thought.

[dutchgal]

I agree with everyone else on this blog..only you can make this decision. One nice thing about the sleeve is that it doesn't resection your gut. If you try the sleeve and it works in controlling your diabetes, great! If it doesn't, then you still have the option of transitioning into a roux and y, even though it might cost you more but what is your health worth? With roux n y first, you never have the option to see if the sleeve would have worked. From my readings, etc, the sleeve does the same thing as an roux n y except it does not re-route the plumbing. I have known people that were diabetics and once they did a low carb, high protein food plan, their diabetes got under control and was eliminated this completely. You apparently have diabetes severe enough where even your Endocrinologist suggests the r n y. My thoughts are that once you have a smaller tummy, your eating will be restricted and you will have to do protein first, healthy carbs second, not so healthy carbs next and hopefully, junk to a minimum or totally eliminated but remember that regardless of which surgery, we're ultimately responsible for what goes in our mouths. We know that it's the crap carbs and junk that are causing the type 2 diabetes....don't know if you are a type 1 or 2.........either or, you have to decide for you as only you and your doctor know what's really going on inside of your body. I think that diabetes comes under control when you 1. lose weight and 2. eat healthier and 3. eat smaller portions unless you are type 1. I think both the sleeve and roux n y do both but it's just a matter of the plumbing. I thought of the roux n y but now that I have read up on the sleeve, this is exactly what I was looking for. Good luck on your decision. Make sure that you base the decision on facts and health and not fear or $$$.

[dutchgal]

but let me add, I have chosen the sleeve because it's less replumbing.........and I am not diabetic.........perhaps if I was, I might make a different choice.

[Rae]

I am scared of the bypass because if worse came to worse and I could not afford liquid vitamins I would become very sick and could possibly die if it went long term. In my mind I am trading one problem for another. Also consider weightloss surgery use to never be covered on insurance and is just now getting popular depending on the employer. Your insurance options may change either with your career or the Navy's plan or even required by law they cover these things. Can we pay $5000 in Mexico for the second half of the surgery? If so, I will start saving in case and if I don't need it I will have a nice nest egg for something else.

[connie]

This is a tough decision--for me the sleeve is the best choice. The Roux-en-y causes me stress---I figure the less messing around in there - like connecting and disconnecting organs--the better for me---THAT IS JUST ME---Let us know what you decide is best for you.

[lynnhuber]

I attended a class at Kaiser yesterday about the different surgeries. She explained that the reason why they recommend the RNY for people with diabetes is because it completely bypasses the stomach and thereby bypasses the Gherin(?-Hunger hormone at the bottom of the stomach), thereby curing diabetes immediately. She said that the Gherin(?) is what causes the problem with diabetes. Just fyi in case it helps you make your decision. Although I too think the RNY is a scarier surgery, I would thing that your doctors know what they're talking about so I would trust their input. Best of luck to you in your decision. I know you will do what's best for you.

[jgilliam1955]

Get a second opinion or a third. If you do decide to do the sleeve you can go to Mexico it's a lot cheaper if you have to pay for it. Either way you have to have something done & start your new life.

[jackiebthe1]

I agree with at least getting a second opinion. Not all doctors are thoroughly knowlegeable of WLS's. My primary wasn't even sure what a vertical sleeve was. Glad he wasn't cutting on me.

[bobbybeegood]

Not all doctors are thoroughly knowlegeable of WLS's. My primary wasn't even sure what a vertical sleeve was.

Same here!

[Kristina Lynn Edmonds]

Thank you everyone for your input. I know it is ultimately my decision, but its nice to have different points of view. I have until October to make a decision, but I have had 4 different drs opinions. Two are recommending the Band. One of those is a bariatric surgeon who pushed the Band at his seminar. The other is my Nephrologist (kidney dr) who thinks the sleeve and RNY are just entirely to risky. The other two recommend the RNY. My surgeon and my endo. None of my Doctors are actually saying I should have the sleeve. I kinda of fell to it because it almost seems to be the middle ground. I should explain that my surgeon initially did recommend the sleeve until he did my EGD then he said he feels I would be better suited to the RNY. Money is not an issue, but Tricare not covering a revision does kind of throw a wrench into my initial plans. I am sure that I will throw everything around in my head for a few months before I make a decision. Thanks again everyone!

[accordingtome]

Check this link out: Weight-Loss Surgeries Compared

I've seen so many people have trouble with the band, that it's the main one that I would not consider. You do have to make your own decision and decide what's best for you and your medical situation and the lifestyle you live.

I wish you well!

[jgilliam1955]

I think the band is on it's way out. It has a large failure rate world wide.