RNY VS. Sleeve, cant decide, need your reasons for why you chose?
I'm also in the medical field (PA) and so I did a lot of research and thinking. I agree with all of the other comments. It also appealed to me that with the sleeve, my normal anatomy was more preserved, and the results seem to be just about as good, with less dumping and nutritional issues. My surgeon also said, you know, it also depends on how well you stick to your diet and how much you exercise -exercise makes a huge difference! The sleeve also appealed to me because I can still take NSAID's afterwards (such as Advil, Motrin, etc.) With RNY, those are banned forever! I really need the Advil for the arthritis in my knees. I miss it so much right now (off a couple weeks before my VSG 3/7 and not allowed to start it yet) -the Tylenol is not doing the trick and you can only take Children's liquid Tylenol, which means you have to take about 1/2 a bottle to reach the adult dose! (8 tsp.) So I am hanging in there -not even bothering with the sticky purple too sweet-liquid Tylenol and just sucking it up. My knees hurt, but my belly doesn't, and it's deflating day by day! So hopefully when I do lose a lot of weight, my knees won't hurt as much either!
I was set to have RNY. When scheduling my surgery date, that's what I told my surgeon I wanted. Mainly, I chose it because the VSG doesn't have really long term data. Gastric bypass has been around a long time in various forms and has a proven track record. My surgeon likes both the VSG and RNY but did refer to the RNY as the "gold" standard.
A week later I found out I was denied insurance coverage. It had to do with a paperwork snafu (at least that's what I was told). That same evening I went to my first WLS support group. Three or four people had RNY and one had the sleeve. They discussed their experiences. One woman in particular talked about her dumping syndrome. She had it pretty badly. Not everyone there did but what she would go through didn't sound fun at all. And the thing is, sometimes she didn't know what would cause it. She would be okay with something one time but not later on. I just thought, I don't want to go through life worrying that if I make a mistake when eating (I mean, you can't always know what's in everything you ever eat) I could end up doubled over in pain. Not everyone has that reaction but this one woman did.
There was another person at the meeting who was planning to have the sleeve. He said he choose the sleeve because of a family history of arthritis and other issues. He wanted to be able to take NSAIDs if needed down the road. That started me thinking about some of my back and neck issues. I had convinced myself that I could get along without the NSAIDs but afterwards I thought, why take the chance? If I end up having trouble controlling my pain, that won't exactly make my quality of life better either. The only reason I hadn't chosen the VSG in the first place was because of the lack of long term results and frankly, those results are up to me. Whether I have the VSG or RNY I could end up gaining weight back so I've decided to have the VSG and take responsibility for myself. If I gain the weight back down the road it won't be because of the surgery. It will be because I didn't do what I needed to do. And in the meantime, I can take an Advil when my head is killing me.
Good Luck. There's a lot to consider. -M
A week later I found out I was denied insurance coverage. It had to do with a paperwork snafu (at least that's what I was told). That same evening I went to my first WLS support group. Three or four people had RNY and one had the sleeve. They discussed their experiences. One woman in particular talked about her dumping syndrome. She had it pretty badly. Not everyone there did but what she would go through didn't sound fun at all. And the thing is, sometimes she didn't know what would cause it. She would be okay with something one time but not later on. I just thought, I don't want to go through life worrying that if I make a mistake when eating (I mean, you can't always know what's in everything you ever eat) I could end up doubled over in pain. Not everyone has that reaction but this one woman did.
There was another person at the meeting who was planning to have the sleeve. He said he choose the sleeve because of a family history of arthritis and other issues. He wanted to be able to take NSAIDs if needed down the road. That started me thinking about some of my back and neck issues. I had convinced myself that I could get along without the NSAIDs but afterwards I thought, why take the chance? If I end up having trouble controlling my pain, that won't exactly make my quality of life better either. The only reason I hadn't chosen the VSG in the first place was because of the lack of long term results and frankly, those results are up to me. Whether I have the VSG or RNY I could end up gaining weight back so I've decided to have the VSG and take responsibility for myself. If I gain the weight back down the road it won't be because of the surgery. It will be because I didn't do what I needed to do. And in the meantime, I can take an Advil when my head is killing me.
Good Luck. There's a lot to consider. -M
I made the choice because the idea of rerouting my intestines scared me. I was concerned about reactive hypoglycemia, not being able to take NSAIDS, dumping, and marginal ulcers. I felt like restriction alone would be enough for me. My surgeon said I'd do really well with either surgery.
HW: 351 Pre-op: 272 Current: 140.7 Goal:160 M1:14 M2:14 M3:11 M4:10 M5:10 M6:12 M7:8 M8:6 M9: 6 M10:7 M11: 6 M12: 4 M13: 5 M14:7 M15: 4 M16: 3 M17: 1 M18: 4
"Glory lies in the attempt to reach one's goal and not in reaching it." - Gandhi
Oh yes, I totally forgot to mention the NSAIDS factor! That was a HUGE factor for me because I depend on ibuprofen for my bad sinus headaches or really, really bad menstrual cramps and I knew my quality of like would be dimished if I couldn't take them.
Goal in EIGHT months!
Highest/Surgery Weight 248 Goal Weight 165 Current Weight 165-175
Starting BMI 33.7 Current BMI 22.1
I'm 42 years young, my height is 6' and I've had no plastics!
I
my sleeve!!!
Highest/Surgery Weight 248 Goal Weight 165 Current Weight 165-175
Starting BMI 33.7 Current BMI 22.1
I'm 42 years young, my height is 6' and I've had no plastics!
I
my sleeve!!!
This is my standard reply when this question pops up every couple of days. 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!
I delivered my daughter 4.5months ago, so this part is a bit old, but pertinent. I was able to have a spinal block and an uneventful csection delivery with zero clotting issues. And, I was on 60mg of Prednisone for over 30 days, plus received IV boluses of steroids as well, and then 3 days of steroids via iv while in the hospital after delivery with zero gastro issues.
P.S. I wrote this before pregnancy. And, just as an update, I'm 8.5 months pregnant and thriving. I have zero issues consuming enough calories/protein/carbs to support my body and another developing human. My labs have remained stellar throughout the pregnancy, and life is pretty good. I am over 2 years out at this point, and couldn't be happier with my decision to have VSG over RNY for my revision. It's been an amazing journey.
P.S.S.
Since the pregnancy, I have been diagnosed with a genetic clotting disorder and the ONLY treatment (zero cure) is a daily aspirin therapy. With VSG, this treatment is possible, if I would have gone with RNY my doctors (surgeon, 2 ob's, PCM) are unsure how this condition would have been treated especially during the pregnancy. Grant it, I only take a baby aspirin every day of my life, but it is an NSAID. Least to say, when my high risk ob found out I had a partial gastrectomy and NOT RNY, he was elated because there really is zero other option for treatment at this point, and the aspirin therapy is working well with my platelets and if all goes as planned, I will be able to have an epidural for my c-section instead of having general anesthesia. Maybe a small issue to some, but being awake for the birth of my daughter is top priority for me.
As a very recent addition; as of 10 days ago, I was advised I would have to be given a steroid(dexamethasone or prednisone) to help get my platelet count up as they have dropped. If I would have had the RNY, this would NOT be possible, and pretty much general anesthesia would be required for the csection. We're looking at other options for delivery such as a spinal block instead of a full epidural, but the doctors are positive the steroids will get my numbers up. At any rate, if I would have chosen RNY, I would surely not be able to have steroids. Looking back, I can't tell you how grateful I am that I was able to choose VSG.
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!
I delivered my daughter 4.5months ago, so this part is a bit old, but pertinent. I was able to have a spinal block and an uneventful csection delivery with zero clotting issues. And, I was on 60mg of Prednisone for over 30 days, plus received IV boluses of steroids as well, and then 3 days of steroids via iv while in the hospital after delivery with zero gastro issues.
P.S. I wrote this before pregnancy. And, just as an update, I'm 8.5 months pregnant and thriving. I have zero issues consuming enough calories/protein/carbs to support my body and another developing human. My labs have remained stellar throughout the pregnancy, and life is pretty good. I am over 2 years out at this point, and couldn't be happier with my decision to have VSG over RNY for my revision. It's been an amazing journey.
P.S.S.
Since the pregnancy, I have been diagnosed with a genetic clotting disorder and the ONLY treatment (zero cure) is a daily aspirin therapy. With VSG, this treatment is possible, if I would have gone with RNY my doctors (surgeon, 2 ob's, PCM) are unsure how this condition would have been treated especially during the pregnancy. Grant it, I only take a baby aspirin every day of my life, but it is an NSAID. Least to say, when my high risk ob found out I had a partial gastrectomy and NOT RNY, he was elated because there really is zero other option for treatment at this point, and the aspirin therapy is working well with my platelets and if all goes as planned, I will be able to have an epidural for my c-section instead of having general anesthesia. Maybe a small issue to some, but being awake for the birth of my daughter is top priority for me.
As a very recent addition; as of 10 days ago, I was advised I would have to be given a steroid(dexamethasone or prednisone) to help get my platelet count up as they have dropped. If I would have had the RNY, this would NOT be possible, and pretty much general anesthesia would be required for the csection. We're looking at other options for delivery such as a spinal block instead of a full epidural, but the doctors are positive the steroids will get my numbers up. At any rate, if I would have chosen RNY, I would surely not be able to have steroids. Looking back, I can't tell you how grateful I am that I was able to choose VSG.
Band to VSG revision: June 3, 2009
SW 270lbs GW 150lbs CW Losing Pregancy Weight Maintenance goal W 125-130lbs
SW 270lbs GW 150lbs CW Losing Pregancy Weight Maintenance goal W 125-130lbs
I'm pre-op, and haven't even had a consult yet, but I'm already decided on the sleeve...
1) I have rheumatoid arthritis and have also had pulmonary emboli - I need to be able to take my NSAIDs, methotrexate and low-dose aspirin
2) I do not want to deal with nutrient malabsorption - I would prefer to get most of my nutrients from food, and that can be done to a better degree with VSG
3) I want a pyloric valve
4) I want to reduce ghrelin, the hormone your stomach produces to say "I'm hungry". VSG physically reduces ghrelin production by removing most of the tissue
5) I do NOT want dumping or reactive hypoglycemia. While some sleevers do develop sugar intolerances, sweets are generally not my downfall. They are, however, a hobby I dearly love. I have spent a fortune on cake decorating classes and equipment and I love it...but tasting is a requirement! I can avoid it for a year or two, but not the rest of my life.
1) I have rheumatoid arthritis and have also had pulmonary emboli - I need to be able to take my NSAIDs, methotrexate and low-dose aspirin
2) I do not want to deal with nutrient malabsorption - I would prefer to get most of my nutrients from food, and that can be done to a better degree with VSG
3) I want a pyloric valve
4) I want to reduce ghrelin, the hormone your stomach produces to say "I'm hungry". VSG physically reduces ghrelin production by removing most of the tissue
5) I do NOT want dumping or reactive hypoglycemia. While some sleevers do develop sugar intolerances, sweets are generally not my downfall. They are, however, a hobby I dearly love. I have spent a fortune on cake decorating classes and equipment and I love it...but tasting is a requirement! I can avoid it for a year or two, but not the rest of my life.
Forgot to add:
6) fibre - I see so many people with RNY having to take laxative & stool softeners and still dealing with constipation, in spite of fibre pills. I'd rather be able to get more fibre from veggies and not risk a cathartic colon from overuse of laxatives.
Oh, and I also agree, while long term results of VSG as a weight loss surgery are not as readily available, gastrectomy for other medical conditions is not new and it has a good safety data there too.
People like me with ~200 lbs to lose are often steered toward RNY or DS, but lots have lost large amounts with the sleeve, and I'll happily take slightly slower loss over malabsorption!
6) fibre - I see so many people with RNY having to take laxative & stool softeners and still dealing with constipation, in spite of fibre pills. I'd rather be able to get more fibre from veggies and not risk a cathartic colon from overuse of laxatives.
Oh, and I also agree, while long term results of VSG as a weight loss surgery are not as readily available, gastrectomy for other medical conditions is not new and it has a good safety data there too.
People like me with ~200 lbs to lose are often steered toward RNY or DS, but lots have lost large amounts with the sleeve, and I'll happily take slightly slower loss over malabsorption!
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