what about weight loss? I am assuming you had the surgery and have lost weight. Between that and the machine, is there any improvement? I know I am frequently very tired but I have not yet had the surgery so still overweight. It would be wonderful to sleep soundly again.

The masks, nasal pillows, etc have come a long way over the years. So have the machines. Mine used to be very loud and bulky. If you "force" yourself to use it for a while you will get used to it. I hated it and fought it the whole way. I prefer sleeping on my side or stomach but with the cpap I can only sleep on side. I can't really tell that my sleep is better but I don't struggle for air either. I suggest you ask to try different masks just so you know which will work best for you.

It's easy for contrarians with an axe to grind to say NSAIDS are ok after VSG. And it's easy for doctors, especially those who aren't familiar with VSGs on a daily basis, to say NSAIDS are alright. Some folks get away with it, sure. Maybe even most. But it's a risk not worth taking. The worst happens far too often.

Most of us worry a lot about complications during surgery, or after. But too many are far too complacent long term. I've seen bad things happen too often with NSAIDS. And I've seen too much crappy advice, even from doctors. The risk is not worth it. Not remotely.

I have sleep apnea, even at goal. Surgeon will not treat you untreated - PERIOD. And if they do, find another surgeon. This is serious business. Why are you guessing what will work. Do the sleep study, you'll be surprised how great life can be if it works. Read a little about the condition and the impacts on the body. You won't sleep without it afterwards. Let's put it this way - With Sleep Apnea, my skin surgeon would not have done the surgery unless I agreed to spend the night in the hospital so I could be monitored. I told him I was near borderline, so I didn't want to do it. He told me to find another surgeon, unless I agreed to stay. That's how serious a good doctor is about this stuff.

What do your endoscopy(s) show, and that possibly along with and upper GI imaging, will lead towards the answer. Yes, an RNY revision is often done to correct intransigent GERD, though it isn't the only solution - that depends on the specific cause and the skill and knowledge of the surgeon. Some docs will diagnose you virtually over the phone (you have a VSG, heartburn, therefore you need an RNY revision...) while others will look at your EDG and upper GI, curse under their breath - twenty years of doing RNYs and they think that they know how to do a sleeve... - then they will explain the problem and the possible solutions. It might be an RNY, or it might be a re-sleeve to correct some shaping issues, or maybe a Nissen (yes, it can be done on a VSG, though not all surgeons can to do it) or other method to correct a hiatal hernia.

When it comes to revisions, they are inherently more complex than a virgin WLS - both in cause and in solution - which puts a premium on finding the right surgeon for the job. Second and third opinions are essential. As with any profession, within the qualified ranks, there are the majority who are functionally competent practitioners who do the everyday jobs well (the 'B' students), the artists and gifted practitiioners who seem to do everything well (the 'A' students) and then those who scraped by with a 'C'. Look through the surgeons' CVs on this site or others, and they all do revisions because they have converted lapbands to VSGs or RNYs, but you need someone a cut above that, and that is the hard part. One proxy for the appropriate skill is to look for a surgeon who has been doing the duodenal switch for some time. As the DS is based upon the sleeve, they tend to have longer and deeper experience in dealing with them, and as it is a fairly complex procedure, that tends to weed out the 'C' and most of the 'B' surgeons.

As to excessive weight loss, you probably will lose a bit too much at first, as it is difficult to "only lose" 20 lb with these procedures. However, deviating from classic WLS rules and diets can help - drinking calories is a good thing when you are trying to avoid losing weight. Likewise common advice in this cir****tance is to go with a high fat, low carbohydrate diet (a la keto or paleo) as the high caloric density of the fats helps keep the calories up, and the low carb helps to avoid classic RNY problems like dumping and reactive hypoglycemia. Also, if going the RNY route, consider carefully the temptation to minimize malabsorption weight loss via shorter limb lengths, as that can promote bile reflux in exchange (always those compromises!)