Was Anyone Else Thinking About RNY Or Band?

I had the band for 5 yrs. and had it removed 5 months ago. I have been posting on both Lap Band and RNY forums. I had decided to go with RNY b/c my insurance wouldn't pay for the sleeve, and I have diabetes. I did lose 45 lbs with the band before regaining back 15 lbs. I am considered a light weight for RNY and was always afraid to have it. Even the bariatric nurse asked "why don't you just get the sleeve?". I replied, because  my insurance won't pay for it but they will pay for RNY. Well, this morning I decided to call my surgeons office before I visit him for the pre-op diet. She told me YES, they will now pay for sleeve surgery. Now What? Anyone else considering another surgery type before you were sleeved? Any regrets?

When I only knew about rny, I decided I would never have weight loss surgery.  I was afraid of absorption problems and other health issues down the road.  My aunt and my mom's bff had it and both had issues. When I learned about vsg, I was thrilled.  Finally, something I would consider.  I'm only three weeks out, but most the veterans here are healthy and happy without any issues from the surgery, it seems.

Thanks Nan, I have arthritis and anemia so I have worries about absorption too. At 3 weeks out, how's the weight coming along?

Yes, because of my thyroid and anemia I would have never chosen any other surgery.  So far the weight loss had been amazing!  Even when I would stick to a strict diet and exercise twice a day, I wasn't losing weight this fast!  And because you're learning to eatsmall amounts, so you don't stretch your tummy or lose restriction, it helps, I think, to get in the habit of eating small, not relying on malabsorption at all, to lose weight.

I also never considered WLS when RNY and the band were the only options.  Here's what I've written about my choice for the sleeve.  I've had zero regrets.

The four WLS are - sleeve, gastric bypass (RNY), lapband, and duodenal switch. My insurance covers the first three, but not the DS.

I ruled out the lapband immediately because the only people I know who have had it are miserable or have needed it removed. The complication rate is atrocious and it only lasts for 10 years or so. It's billed as being a "reversible" surgery, but the damage it can cause, like from erosion into your esophagus, is permanent. So no lapband for me. Here's an article on that topic.

The choice really boiled down to RNY or VSG and I chose the sleeve for a number of reasons. (Even if DS had been an option, I would not have chosen it.)

1. I really like the simplicity of the sleeve. All it does is remove 85% of your stomach. That's it.
2. I dislike the idea of having my intestines rerouted.
3. The "good" malabsorption that the bypass gives (of fats) is a temporary thing that only lasts for a few years whereas the "bad" malabsorption (of vitamins and minerals) lasts for forever. That's not worth it to me.
4. The sleeve is restriction only, no malabsorption. This also means that I CAN eat anything at all. Fats and sugars won't screw up my bowels the way they can for the bypass. (Of course I still need to make healthy choices, but that's a choice, not something that my surgery requires.)
5. With the bypass, you're left with a remnant stomach that can't be scoped. That scares the crap out of me. First, the idea that I have this weirdly connected non-stomach but then to not be able to get it checked out with an endoscopy if there's a problem? Eek. Do not want.
6. My understanding is that complication rates with the bypass are significantly greater, especially longterm due to malabsorption. While I will be taking vitamins for the rest of my life, chances are that I won't end up in the hospital if I stop because the sleeve has no malabsorption involved.
7. For the most part (and there are exceptions) the people I know with the sleeve look and seem healthier than the people I know with the bypass. That's nothing scientific though.. just a gut feeling.
8. The sleeve leaves you with a fully functional pyloric valve at the bottom of your stomach whereas the bypass gives you a stoma which can stretch over time.

. Those are all interesting facts and reasons. I agree with them all. I do want to be able to eat healthy of course. I do worry about absorption problems. However, I also worry about acid reflux. I had that so bad with the band that after trying to deal with it a few weeks (Too long) I hurried back in to my surgeon to have a 50% unfill. that was the deciding fact for me b/c by having to do that, I could no longer lose weight. Even before the unfill I had stopped. Everything else I totally agree with. Do you have reflux problems?

I took a PPI for a month post-op and I've had to take two other 14-day courses in the last 9 months.  So, no, I don't think I have a problem with reflux.  

Reflux is often a result of a hernia and it clears up when the hernia is fixed.  

Many Sleevers do have Acid Reflyx for life. It's common but if you take your PPI you won't suffer with it. I had the LapBand and loved it. I lost 271 lbs in 22 months, but eventually had to revise and my surgeon said the natural choice for a revision from the Band is the VSG. Both restrictive procedures. 

One thing besides the malabsorption issues with RNY is regain. I know so many who have had total regain. My bf got the RNY the same month I got my band. She lost faster - we both started at almost 500 lbs. I am now at 144 and she's at 450. Very sad. 

Regain is an issue with any WLS, not just RNY.  It's always possible to eat around a surgery and it's always possible to slip back into bad habits.  That's why it's super important for all of us to work on our heads in conjunction with working on our bodies.  

Absolutely but in my WLS support group - 8 out of 10 RNY patiebts have regained 80% or more. Sleevers have a little regain but it's not significant - I work with patients who desire revisions so I know there are ways to eat around any WLS. The reason RNY had higher regain stats is the absorption of the bad stuff returns and if the patient hasn't learned how to eat properly and relied on dumping to lose weight, they begin to gain around the 2 year mark.