Educated sleeve folks, I am reaching out for help again today

( Ok I had a few questions from members because they did not know much about my story and wanted details before they could help me on a better level of understanding, so here I am posting this hoping to help)

 I have been through this for close to the past 7 years. I had been denied through insurance when I was starting this journey so long ago and at the time i was 420 pounds. (I am 5'10) Since then, along the way have been down to 320, back  up to 412 and then down to 318 again. (again over a 7 year span)

Now I am sitting at 330's to 340's and been below 350 for over 2 years. The 2nd time for surgery i was a day away from the RNY and cancelled. I was terrified of the surgery. When i was over 400 it was the ONLY choice for me and i wanted it more than anything. I think at the 2nd attempt, knowing i lost over 70 pounds two different times made me think it was not the only answer anymore. (this I am currently working out my emotions and fears on a weekly basis with a psych)

3rd time lapband, and that was a stupid rash decision on MY part for what surgery fits ME and it was due to fear of the RNY but did not fully understand the band enough, and when i discovered the numbers, issues, %'s, etc etc, about 2 weeks before surgery and i cancelled that one too. The band is NOT the surgery for me.

I am on the path right now of working towards the RNY again with my surgeon, and can have it in 6 weeks when it comes to him and my insurance co.

I do understand there are other surgery options but with my insurance only covering two, and not being able to afford it, honestly, otherwise I was not looking elsewhere.

Recently I have discovered that my surgeon has been doing the sleeve for the past few years, and I know that my insurance co and my employer are contracted with my surgeons office and I JUST may be able to get them to approve it with appeals and surgeon peer to peer support IF I DECIDE that the sleeve is what I want to do. IF i go that route I will have to work hard to get them to approve.

SO before I jump in completely on any of the two surgeries, this time I am learning all i can on both, figuring out on a emotional, mental and physical levels WHICH is what i need. RNY, Sleeve or none at all. Lately none at all is not really the direction I am heading.

I loved the restriction part of the band with not having the malnutrition. I dont like the idea of the band and with my weight EVEN Though i lost that much weight twice, its not ideal. I want the stronger tool. RNY, its an option but i really fear the re routing, the blind stomach (cancer, ulcers later on) and the malnutrition. SO this is the road that led my thoughts on the sleeve.

So before I see my surgeon, any thoughts on the sleeve, experiences, any questions i should ask the surgeon since they are fairly new to the sleeve but an accredited center and been doing RNY and band for years, plus they are the major top local stomach surgeon to go to for any OTHER stomach issues that need to be handled, or other things to ponder on is so much appreciated.

Thanks again

I would suggest you read all the information you can find on both the VSG and the RNY. Most of us here on the VSG board are going to be pro VSG. After all, it's the WLS we chose! You have to decide what is best for you - no one can do that for you.

My doctor gave me the choice of surgeries - RNY or VSG (he will no longer do bands). My insurance covered whatever he recommended. I chose the VSG really for two reasons. The first one was that I was very concerned about  the malabsorption issues and rerouting the guts with RNY. The second was that the RNY doesn't retain the pyloric valve (except in the blind stomach where it is of no use). SCIENCE is showing that the pyloric valve is a huge factor in long term weight loss maintenance. I am also a volume eater and a good restrictive surgery is what I thought was best for me.

Good luck on your journey and with your decision.

 the sleeve worked FOR ME, because i was a volume eater and had weird hunger signals that told me i was starving when i knew there is no way i could be...  i was also not interested in the malabsorption....  but the sleeve is what fit MY needs..  you will have to decide if it is what fits your needs...

just a thought -- the sleeve is the first part of the duodenal switch...  if you were to get the sleeve and it didn't work as well as you wanted it to, you can always go back for the rest of the procedure, which would add the malabsorption component...

all in all, it comes down to what YOU need....   research, research, research...   or as they say in the carpentry world -- MEASURE TWICE, CUT ONCE!!

good luck in your journey...


jeris

Building on the revision thought, not only is the VSG fairly straightforward to revise (some would say "complete") to a DS which is the only procedure that has a statistically meaningful advantage on the regain front, the RNY is much more difficult to revise to a DS should that become necessary due to poor weightloss or regain issues. There are only about a half dozen surgeons in North America who are actually qualified to do RNY to DS revisions.

 
Looks like your about a 50 BMI

The VSG is not a standardized procedure......

Your chances are increased greatly if your surgeon has a high success rate with High BMI patients.

That would be the first thing I would research....

frisco

 For a non bias opinion, here are 4 videos to watch that compare a few of them. Also he has a few other videos that answer questions from sex post-op, to hair loss. Very informative channel!

Describes VSG: http://www.youtube.com/watch?v=zRZ-nOc9fQ0&feature=mfu_in_or der&list=UL 

Lapband vs VSG: http://www.youtube.com/watch?v=5rTcnv40efE&feature=mfu_in_or der&list=UL 

Bypass (RNY) vs VSG: http://www.youtube.com/watch?v=Hk5F4mmxD2M&feature=mfu_in_or der&list=UL 

Plication vs VSG: http://www.youtube.com/watch?v=iSLdJlbVchI&feature=mfu_in_or der&list=UL

The sleeve was not on the official approved list for my ins but the office submitted it and if was approved. I was a little worried until I saw that it had been paid for but I did not have to go thru an appeal. I let the fear of the appeal process hold me back and now I wish I had not. Good luck on your decision.