How did you choose?

Hi,

 

I am in the process of making an appointment for surgery and I was all set to have VSG, but now I am reconsidering RNY. Can someone help me think through this and tell me why you chose RNY? What are the pros and cons and are you happy you made the choice?  I appreciate hearing any stories or comments. Here is a little about me- I am 25, weigh 293 lbs but otherwise healthy except bad heartburn/reflux and some jooint pain, but I am anticipating health problems which is why I want to do this now. My biggest concern about RNY was not being able to absorb all the nutrients, and I already have a tendency to be anemic. I like the VSG because it seems like a less complicated procedure and I also like that the levels of the hormone (not even gonna try to spell it but the one that makes you hungry) go way down. Any thoughts? What made you chose one or the other? Thanks!

If you've got bad heartburn or reflux, I would not do VSG.  It often makes that worse.  RNY, on the other hand, usually fixes it.

As long as you take the appropriate vitamins, you shouldn't have nutritional deficiencies.  If you get labs done regularly and then take the vitamins you need, it should not be a serious problem.  Do you take iron currently since you know you are often anemic?

I was given the choice between a sleeve or RNY. I chose RNY for several reasons:

1. I have had reflux for almost 20 years! It is well controlled on medication, however, long term use of PPIs (proton pump inhibitors) bring their own host of problems with long-term use (academics are still researching if long-term use of PPIs cause increased osteoporosis). When I had my EGD done prior to surgery, I had 100+ tiny sessile polyps in my stomach fundus from using PPIs for many years. From my research and my discussion with my surgeon, the sleeve would not help with my reflux and it was more likely to make it worse (thus increasing my risk of esophageal cancer, exacerbating my asthma, continuing to take PPIs, etc).

2. I wanted the restriction AND the malabsorption. I realize the malabsorption isn't life long, like a DS, but being as I started at a BMI over 50, I wanted a bigger bang for my buck! I, too, have issues with anemia and low levels of vitamin D and potassium (all pre-op). I take my vitamins and supplements daily, so we'll see what my next round of lab work shows (I'm only two months post-op).

3. I researched and read a lot of scientific articles about RNY and I was intrigued with the changes they are finding in a person's biome and gut flora AFTER RNY (the gut microbiota replaces fattening microbes with slimming microbes). It is pronounced enough that they can take the gut flora from a mouse that had RNY and transfer that into another mouse that is overweight and that mouse will start losing weight like the RNY mouse.http://www.reuters.com/article/2013/03/27/us-obesity-surgery -bacteria-idUSBRE92Q0ZQ20130327 So it was compelling evidence to me that there is something much more amazing and helpful taking place after RNY than just the restriction and malabsorption.

Furthermore, research that came out earlier this year that suggests the DNA alteration of children born to RNY mothers may lower their risks of obesity, hypertension, and better fat regulation, so that was interesting to me because I hope having a baby might be in the cards for us in this later stage of life! http://arstechnica.com/science/2013/05/parents-have-gastric- bypass-childrens-dna-may-receive-the-benefits/

There was also an interesting thread not too long ago about ghrelin and why people who have RNY might outlive those who had VSG or DS (he includes a lot of research links) http://www.obesityhelp.com/forums/rny/4657501/Update-re-Ghre lin-Why-RNYrs-might-outlive-VSG-and-DS/

4. RNY is the "gold standard." I realize that may change one day and that the sleeve is the hot new procedure, but I was more comfortable having years of research to back up this procedure. 

While there are definitely some downfalls to RNY, such as not being able to take NSAIDS (doesn't matter to me because I am allergic to them anyway) and the risk for malnutrition of vitamins and minerals, I am still exceedingly happy with my decision. The best advice I can give you is to research on your own. Word of mouth is great, but read actual scientific data and speak to the professionals because every person's experience can be very different.

I wish you all the best with making your decision and starting your new life. =)

Very well put.

It is a life changing experience. Not a fix all.I have to go to therapy also.I had the RNY done in October.I chose because I had a lot of weight to lose.I don't mind taking vitamins daily you get used to it.I feel better than I have in 20 years.I am down almost 60 pounds since weight loss journey. I am not sure how much I weighed the day of surgery they didn't put me on a scale.This is one thing you have to figure weigh out the pros and cons.There are websites that will say all of the great results from each surgery but the site is ran by the surgeons that do the procedures.I feel great.I know this is just the beginning of the journey after I lose that is when the hard part starts.Not that days are hard now but to maintain is different and I am nervous when I get there.But I will continue to take care of myself.Best of luck to you.

During my pre-op testing, the EGD found that I have Barrett's Syndrome (which is caused by years of bad GERD, which I did not even realize that I had).  My surgeon strongly recommended RNY over the other choices for me because research shows RNY is therapeutic for Barrett's.  I looked it up myself and I did find evidence that RNY was the best for people with that kind of issue, and if you have bad reflux that includes you.  I will be scheduling a follow-up EGD soon and am looking forward to hearing the results.

While my weight loss has not been as dramatic as it seems for those who have VSG, I have gotten somewhere and should reach my goal sometime in 2014!  And I can't begin to express how much healthier I am, not to mention being able to do so much that I was missing before.

Good luck to you in reaching your goals!

Ummmm -- over 100 pounds lost in less than a year is AMAZING girl! I beg to differ with you - that IS dramatic!!! Pat yourself on the back - you're walkin the walk and talkin the talk!

I was really torn between the two also.  My husband & I spoke often about the decision.  My DH was always concerned about the possible changes to our habits of eating out at the drop of a hat.  He was concerned I would regret not being able to eat ..,, he sided toward the sleeve surgery (5 oz compared to 3oz stomach).

I love my husband but I didn't want the possibilities of old habits ruling my life yet again.  I've read about sleeve procedures that later did revisions to bypass surgery.  I wanted to do it right the first time with the best possible outcome.  

I also spoke with my sons.  Explained the procedures and got their opinions.  They always have been a great support and continue to be my greatest encouragers!  They are all married but wonderful sons!

I am very happy with my decision -  my DH is too!

By my calculations you're losing nearly 6 pounds a week (average)!!! Dayum - I'd say you chose wisely!

I agree with all the responses above.  The other factor mentioned by my doctor is that RNY has been around for longer and there is more long term data on its success.  I had a lapband for five years and found out the hard way that sometimes the latest isn't the greatest.  In the end my decision was to go with the tried and true, long tested surgery.  This is in no way saying the sleeve isn't a good surgery, I just wasn't willing to take the risk because I've already experienced one failure.