help ryn vs sleeve need some advice

I asked the same question in ryn...i wanted to see your responses too...thanks

As some of you know i am scheduled for bypass surgery july 1st.....that being said i am second guessing my decision and wondering if sleeve is better choice for me.....

So i have a bmi of 35(liteweight i think), i have lost weight in the past but always put it back on....

I do not have diabetes, or high blood pressure.....but i was gustational with my children...and diabetes runs rampid in my family....my father just passed away from it and the doctors have been on my case about losing weight or i will end up with it...

I would not say i am a huge sweet eater.... I am a carb a holic.....Do carbs make you dump...  I have 75 pounds to lose.....my like with the ryn is I am hoping that if i eat any carbs it makes me pay....and i am not sure how the sleeve would work with that....

All these posts on seizure, low blood sugar, etc have me very overwhelmed...and questioning my decision.....

any suggestions would be helpful...would you do the sleeve or the ryn?

Thanks in advance...

I would do the sleeve again in a heartbeat! I didn't do the rny because I did not want malabsorption of vitamins and minerals (I already had low vitamin D and iron). My cousin had rny and has to get iron infusions every Friday. I did not want dumping. I do not like to throw up. Gastrectomies have been done for many, many years, so I know they're safe in the long run. That's just a little part of it all, but enough for me.

I too was considered a lightweigh  bmi 38.9 starting out, now 27.  I was scared to death of the bypass.  The malabsorption of fat and calories stops around 2 yrs out but the malabsorption of nutrients from food lasts forever.  I also know several people who gained the weight back a few yrs down the road and others who have had complications due to the messing with the plumbing, re routing your intestines.  My problem was i ate too much, with my sleeve i eat like a normal person and i love my sleeve.   Its the best thing i have ever done for myself.   I have lost the weight slower than some but i am very happy with my results and i'm still losing.  I would say the sleeve is a wonderful choice and i wish you luck, whichever tool you choose you have to make the changes in your diet and exercise levels.  :o) jeani

I can only tell you why I chose VSG over RNY: here is my standard reply.

I won't try to sway anyone one way or another, but I'll give you my reasons for choosing VSG over RNY for my revision from the band. You can also check out the revision, failure, and food issue forums on here to get an idea of some long term RNY patients. For me, it was never an option. The cons outweighed the pros.

The VSG was my 2nd, and final WLS. I could have easily had RNY, but I fought to have VSG as my revision from the band. Some factors I considered in deciding on VSG. The pouch that RNY offers is similar to the pouch with the band. Least to say, a pouch sucks, I love having a normal tummy, just less capacity and still fully functioning.

1) No blind stomach left behind that can be difficult to scope yet can still get ulcers and cancer.

2) 2 years max on calorie/carb/sugar malabsorption, but a lifetime of vitamin/nutrient malabsorption. This process is called adaptation, and it happens with intestinal bypass surgeries.

3) I had a pouch with the band, and it sucked. I'm pretty fond of my pyloric valve and the sleeve let me keep it. I love having a normal functioning stomach, just smaller in capacity.

4) Regain stats and #of RNY patients seeking revision truly scared the poop out of me

5) I have too many friends in real life that struggle with vitamin deficiencies post-RNY, and most of them either never got to goal, or have gained back a significant amount of their weight.

6) The long term complications with RNY were too numerous for my comfort level. Pouch or stoma dilation, strictures, vitamin/nutrient deficiencies, ulcers,

7) I researched gastrectomies that had been performed for stomach cancer and ulcer patients, and found comfort in the long term results and minimal complications of patients that had lost most or all of their stomachs had dealt with over several years.

8) I was a volume eater, and knew a restrictive only procedure would work for me. That was my thought process when I got the band, and I thought I could beat the odds on complications. Sadly, the band only lasted 8 months before I had to revise.

9) I did not want to have food or medication restrictions. I chose WLS to have a "normal" life, and I think it's normal to eat a couple of cookies. With RNY, I wasn't willing to go through the possibility of dumping if I wanted to have a couple of cookies, or a slice of cake on occasion. The big scare for me is medication restrictions for life. NSAIDS and steroids are a NO GO for life with a RNY pouch. I realize that I may never be diagnosed with a condition or disease that requires steroid use, but it is possible. I want the best long term results with the least amount of complications. Malabsorption is not anything to play with in my mind, and I was not willing to take that risk.

I lost all my weight in my ticker with the exception of 7lbs with the sleeve, and I did it in 10.5 months. The 115lbs fell off the first 6.5 months, and then the rest I lost as I was getting into maintenance over another 4 months.. It's been a fabulous journey, and I'm easily maintaining with zero issues for nearly a year at this point. I want to add that every WLS regardless of your choice will require discipline. Only a percentage of RNY patients dump on sugar/fat, pouches and stomas stretch, then you have the medication restrictions. I'm not trying to convince you, but these were my concerns when I knew I had to revise from the band. I started at 263 the day of my revision and today I weigh 127lbs. I bounce on the scale 125-130lbs any given week, and I couldn't be more ecstatic!

Best wishes in your research!

P.S. To add to this since things have changed a bit since I wrote this. I'm 20 weeks pregnant, thriving, the baby is perfect, VSG has not complicated my pregnancy in any way, form or fashion. I'm able to consume enough nutrients/calories to support my body and baby. I do not have to take additional vitamins because of malabsorption and all my vital nutrient/vitamin levels have remained stellar for my 2 years post-VSG.

I would recommend you checking out the revision board to see just how many RNY patients are looking to revise to DS or ERNY because of regain, or other complications. There is NOT one human that could pay me to have RNY.

P.S.S
With the revision in June '09, I was diagnosed with a clotting disorder. With the pregnancy, they have now put me on a daily aspirin dose. Guess what, Aspirin is an NSAID, and if I had chosen RNY, I would have to give myself lovenox injections, and increase my clotting issues. I clot slowly because of a platelet malfunction, they stick to themselves instead of being free floating. Now, the aspirin is a daily thing. With a pouch, this couldn't happen. I'd be really screwed and not be able to moderately treat my condition which has no cure, and is genetic. They're trying to thoroughly diagnosed the clotting factor and figure out if I can get off the aspirin and hopefully be able to get some answers on the platelet factors.

Wow! Outstanding reply.  I may be cutting and pasting this.  I do have a question about the NSAID though.  As I understand it they are a no-no for sleeve patients too. 

I've been able to take NSAIDS since about 6 weeks out without issue. I've taken all of them from Aleve to 800mg RX Motrin. Just like I did with a big stomach, I take them with something on my stomach be it a couple of crackers, or some yogurt.

100s of patients have won appeals with insurance companies because the need for taking NSAIDS is not possible with the RNY. I've read up on gastrectomies for stomach cancer/ulcer patients and everything I've read states that NSAIDS were okay for them.

I have read on here that a lot of surgeons suggest no NSAID with the sleeve, but even the pioneers of VSG state there are no medication restrictions including NSAIDs.

I'm only not allowed to take them with the pregnancy which is standard protocol for all pregnancies. That is why they are diligently trying to get the clotting disorder diagnosed and resolved so I can get off the aspirin regimen ASAP.

I'm a light weight, too. I barely met the minimun weight requirement insurance insisted on. I'm losing quite well. Surgery and recovery, for me, was a breeze. Coulnd't believe how well it went. i feel amazingly well. Great, in fact.

I read on this forum all the time about diabetics leaving the hospital after surgery not needing insulin any more. Maybe you'll hear from some of them.

My dietary habits have changed dramatically. It just happened. My 2 main food groups used to be carbs and sugar. Didn't need anything else - just carbs and sugar. Since surgery I've been all but carb and sugar free. I don't miss it. Don't want it. Don't mourn it. Don't think about it except for when I'm reading food labels. I avoid all white food like the plague. For me, it's toxic and I stay away from it.

You may find the following helpful;

http://www.obesityhelp.com/forums/vsg/about_vertical_sleeve_gastrectomy.html

http://www.obesityhelp.com/forums/vsg/cmsID,8457/mode,content/a,cms/

All the best in making your choice. Doing your homework is very important. 

I think before you dive into the RNY you need to read up on it more... the majority of people DO NOT dump.. only something like 30-35% do, and it's usually a combination of fats and sugar that does it or just plain simple sugar.. If you are scheduled for July and are hoping the RNY will cause you to dump on plain old carbs like pasta bread or chips you are not informed nearly enough to do this to yourself. You cannot base this type of decision solely on the hope that you have a complication (dumping IS a complication) that does not even effect the majority of people that get the RNY! You are going to be very disapointed to realize that yes, you can have plenty of carbs and not dump with the RNY.

Since you are asking on the sleeve forum, you know you're going to get all positive responses in favor of the sleeve  ;) .. but frankly with your weight and ability to lose- I wouldn't do the RNY. I would strongly suggest postponing any surgery and research the types of procedures a heck of a lot more..

The rare Sleever dumps, but it can happen.. as well as it can happen to non-altered folks too- it's not just a surgery thing. Intact people can have it happen as well.

Good luck with whatever you choose!

There is less chance of dumping, almost none, with the sleeve, but neither of these options will "force" us to stop eating crap if we want to. If we want chips, cookies, mashed potatoes with whole cream, butter, cheese and bacon, there is a way around all WLS.

Bottom line, do your home work, especially since you're dealing with diabetes. These are tools for us to use while we do the hard work of changing our choices. No cures for addictions and compulsive behaviors here dear, just good people doing what we need to do to become our best selves yet.

Glad you're here. Have a blessed journey.

i agree 100% with the last two replies....I know RNY patient who dump...but still eat stuff that makes them dump!...they just do "planned dumps!"  wait till they are at home or on weekends!  you can "eat around"   ANY surgery....including VSG.....i can eat everything...especially carbs!  I CHOOSE..what goes in my pie-hole....(sometimes it actually IS....pie ha ha !)  But for the most part i choose my health.  Good luck!