Hi!  I'm in the process of deciding between gastric bypass surgery and gastric sleeve surgery.  I would like to hear from people who have had either surgery and hear your positive and negative feelings about either one.  You can help me make an informed decision.

Here we go again...

"I was not willing to risk needing B12 shots, iron infusions etc that I saw fairly commonly on the DS board."

These are still risks with the VSG. I see many VSGers take B12 supplements (not always injections - sublinguals are enough for most, VSGers and DSers alike). Iron issues with the VSG are also not uncommon, with the most vocal example on the VSG board being everyone's beloved OldMedic.

I have a DS (longer common channel, but still technically a DS), and I stopped my B12 supplements because I simply found I didn't need them. It's the VSG part of the DS that makes B12 a common supplement for DSers because it's the VSG that reduces the amount if intrinsic factor produced by the stomach, which is required for proper absorption of B12.

"I was also not wanting to be wedded to having to take mutliple doses of various vitamins and supplements daily for life or be at major risk for major health complications."

ALL weight loss surgery patients should be taking supplements daily, regardless of procedure type. I understand that you probably meant you didn't want to have to take as many as most DSers take, but your statement sounds like you don't need any supplements daily at all. Generally recommendations for VSG patients for daily supplements include 2 multivitamins and at least 2-3 doses of calcium citrate (taken at separate times since the body can only absorb about 500-600mg calcium at one time); if you also need iron, then you're up to possibly a 4th dose of pills for the day since calcium and iron shouldn't be taken at the same time. And then there's the vitamin D that most Americans need anyway, even without surgery. Pills 3-4 times a day is not an uncommon scenario for VSG patients.

On March 27, 2011 at 1:22 PM Pacific Time, Susan S. wrote:  You still have the 'window' open. It will close soon and then you will wonder why on earth you squandered that period of time when weight loss is actually easier. Because once your malabsorption is reversed (happens by 18-24 months out) it takes a different level of effort to lose anymore weight.



Ok.. what???? What do you mean the malabsorption gets reversed????

Can anyone tell me the benefits, the down sides, and any other thoughts you might have on these procedures?

Thank You!

 Still pre-pre-op here (research stage). After much research I came to the conclusion thats DS was right for me. But after much more research I realized there is no way DS will be covered by OHIP here in Ontario. Self pay is (far) out of the question. It's just not possible for me. So I guess my choices are to "settle" for a RNY (this isn't an attack on RNY, it's just not right for me), or to forget about the surgery altogether. (Yes I know I have the option of band or VSG as well, but to be honest with a BMI of over 50, I do not think I would have much sucess with either one). My heart and mind are just SO set on DS that I couldn't imagine being happy with anything else. Like I said... sad reality :(

 I thought I was set on RNY.. but now Im not so sure becuase it seems as though people are having more success losing a higher amount of weight with DS. Input would be awesome....not sure what to do. I have about 250lbs to shed.

I have seen some VERY contradictory posts here about how difficult/painful/troublesome iron infusions are.  I'd like to see what people's experiences are with them, in one location, because some of what I have heard surprises me.

I find the infusions to be very easy, very convenient and very effective to get my iron-related numbers up.  So far, they have lasted 18 months at a time, and compared to the hassle of taking oral iron (stomach and gut upset; lack of effectiveness; timing taking it away from calcium; cost), I think getting infusions is a great solution to the problem of getting iron levels in range.

However, I have seen some VERY different experiences here, including numerous people who have to get treated with benadryl (and thus have to have a ride to and from the infusion, lose most of a day due to being sleepy, and take up the time of another person), and sometimes steroids, and I wonder why that is?

Background: My iron/hemoglobin/hematocrit/ferritin levels were OK, unsupplemented (except what was in my prenatal) for the first 5 years after my DS.  In retrospect, I was always on the low end, and over 5 years they slowly drifted down.  Finally, based on my low ferritin level (18) at my 5 year checkup, my surgeon recommended supplementing with Multigen.

OMFG.  Not constipation in the classic sense, but compared to the easy soft DS poops and with my IBS, it was very uncomfortable.  And didn't do squat to increase my ferritin - in fact, it went down further.

So I switched to Proferrin ES.  MUCH easier on the stomach and guts.  But didn't do squat to my ferritin level.

Finally, after my 6 year checkup, with my ferritin down to 12 and my hemoglobin and hematocrit dancing on either side of the lowest numbers, and facing three plastic surgeries (although I only got one), I got a referral to a hematologist who works with DS and RNY patients.

I was scheduled for three Venofer infusions.  The first one was done slowly, to make sure I didn't have an allergic reaction (these usually manifest with a drop in blood pressure).  They checked me carefully every few minutes, over a 2 hour slow infusion.  No problem.  So the next two infusions were done in one hour - no problem.  My ferritin went up to 79.  The appointments take about an hour, and for me, the only issue is that the hematologist is 40 miles away - but I won't even try to switch, because he knows my surgeon and is cooperative in prescribing infusions before things get too low.

At my 7 year check up, my ferritin had dropped somewhat (56), but was still OK.  Then I had my levels tested again in December, and ferritin had dropped to 23.  Since the hematologist "gets" WLS patients, he scheduled me for 3 more infusions, even though I'm still in the low normal range.  I just had the second infusion today.

I was chatting with the nurse who does the infusions today, and I asked her how common it was to have problems with them - I've read SO many reports of people having to have benadryl or other meds in order to tolerate them, or other issues.  And to me, the infusions are SO easy, so convenient, that it would suck to have problems taking them instead of iron pills.  To my surprise, she said that over the YEARS she has been giving iron infusions, almost always Venofer (though occasionally Ferrlecit, if for some reason the Venofer is contraindicated, although it is more common to have issues with it), she has only run into an iron infusion allergy FIVE TIMES.

So, I was telling her what I had read here, and she was surprised.  She guessed that perhaps some hematologists have simply made it a practice doing the antihistamine treatments, without bothering to find out whether the person is actually allergic to the infusion.  Or used Ferrlecit when Venofer might be better, or worse, using iron dextran, which has a much higher risk of allergic reactions.  In other words, making it more difficult than necessary.  See http://health.nytimes.com/health/guides/disease/anemia/treat ment.html

So, I wanted to ask, if you have had iron infusions:

1)  What kind (product) did you have?
2)  Did you need to have benadryl, steroids or some other co-treatment?
3)  Did you have any problems with getting your infusion?
4)  How often do you have to have them?  E.g., for me, 3 infusions, a week apart, 18 months between rounds.
5)  Is there any reason you don't prefer to have infusions rather than take iron pills?
6)  If you pay for them, how much do they cost you?

I sure hope the numbers are not as bad as the impression I've gotten has led me to believe.  I also hope that people are being given the most effective and safest version of iron infusions, rather than the cheapest.

Don't misconstrue what I had said.  From the simple fact that DS has BOTH the sleeve AND malapsorption, they do have an easier time then someone with just restriction.  If you ever read any of my posts, you will clearly know that I don't diss any surgery types and I think ALL of the surgeries have many success stories.  These are just tools at the end of the day and we MUST work our tools in order to have long-term success.  However, statistically speaking, the DS still has the best chances for keeping the weight off long term and that is an important fact for someone that is considering surgery.  From my own personal experience, the VS defininetly helped restrict my food initially, however, in time, I can eat a lot more.  It was through hard work on my part by hitting the gym 5 days a week and weighing and journaling my food that I was able to get rid of 90% of my excess weight. 

All I am saying is that when the restiction is no longer very "restricted", it would be great to have a second tool that actually helps your body not absorb ALL the food that we eat.