questions

I had a surgeon tell me since I had lupus I couldn't have any kind of WLS. I really need help lossing weight and am wondering about the experiences of those who have lupus with surgery. Also how do you manage to take all your pills with those little pouches? I have been reading about a gastric sleeve and was thinking of asking for that and then have the rest done like an RNY. I just want to ensure I can still take my prednisone because without it I have CNS lupus issues. I have an initial appointment to learn about the surgeries available the 3rd. My husband is going to get surgery with me.

I had a laproscopic sleeve done 9 days ago.  I have systemic lupus.  I'm not sure why your Dr. told you no?  Maybe yours is more severe?  I do not take prednisone but do take hydroxychloroquine.  Eventually I will be able to swallow my pills normally but right now they are just having me cut them into 2's.  My other medication came in liquid form.  In fact I think me having lupus even helped my insurance approve the surgery.  It will be a lot healthier for my joints to not have to carry such weight.  If you have any other questions just ask : )

                                                                                                            Erin 

If your rheumatologist is on-board with you have WLS, there should be no reason why you can't have surgery.  About 5 years ago, I asked my rheumie and he said "no way" and the subject was dropped.  In early 2008, I thought about it again...had a new rheumie.  He was completely on-board.

You should not have a lap-band.  According to the manufacturer's recommendations, if you or a relative have any autoimmune disease, the lap-band is contraindicated.  That said, I did have a WLS tell me he had no problem with "off-label" use of the lap-band on me.  "I" wasn't comfortable with the off-label usage of it.  And was never really interested in the lap-band anyway.  And there are people with lupus on this board who have had lap band and been fine.

With RNY, you CANNOT take NSAIDS or STEROIDS, which would mean you would have to give up your prednisone.  Also, if you take anything for pain that isn't acetaminophen based (i.e. Advil, Aleve, Excedrin, etc) you would have to stop that too.  I was told by my surgeon if I needed one of the "no-no" drugs, I could potentially take it for a VERY SHORT PERIOD of time with the use of a proton-pump inhibitor and that would be okay.  So, for lupus pain relief, I've switched from ibuprofen to darvocet. 

If you truly can't give up your prednisone, you might want to look at the sleeve.  It's is a purely stomach surgery and might be the best choice.  I considered it due to the lupus issues, but had my heart set on the RNY...and couldn't do the sleeve anyway, as it turned out, because my insurance wouldn't cover it.

You mention the sleeve with the "rest done like the RNY".  Are you referring to the DS?  The worst choice for a lupus patient especially!  I have very mild kidney issues and it's even questionable if they are lupus related.  My nephrologist NEVER would have allowed me to have the DS due to potential kidney issues.  As lupus patients, we are already prime breeding ground for kidney problems.  Most lupus organ involvement begins at the outset of the disease.  But the kidneys can become affected at any time during a lupus patient's life.  In other words, you can live with lupus for 20 years without kidney involvement and then wham, have lupus related kidney issues.  Most DS patients aren't aware, but my understanding is the DS comes with a higher risk of kidney issues than the other WLS.

I hope I've provided you with some helpful information.  The most important thing I would tell you is that you need to discuss WLS with your rheumatologist and any other specialists you have before moving forward.  All my doctors were amazing.  I decided I wanted surgery and 1-by-1, I went to each doctor to ask permission.  They were all on board.  They all wrote beautiful letters for my insurance company on why this surgery was a medical necessity.  And they all said we would be monitoring everything and adjust meds accordingly (like switching to prescription Darvocet so I could stop the ibuprofen).  I'm the closes****ched WLS patient I know.  And when my white blood cell count dropped below normal limits, I was immediately sent to a hematologist.  It appears to be benign and just related to the lupus, but there was no wasting time...they wanted it checked out immediately.

Good luck on your journey!
Elli

I just wanted to add that I have Lupus and other syndromes that accompany it, and I want to have WLS, but not sure which direction to go despite a lot of research.  I found your post very helpful to me, personally.
Thank you. 

Your welcome.  Good luck on your journey.  If you have any questions that I might be able to answer, please feel free to PM me.
-Elli

Thanks. By having a gastric sleeve and then the rest like an RNY I mean having the doctor do the bypass of the intestine like they do with the RNY. It would be a modified RNY. I have heard of it being done but it is not common.

I haven't heard of that...sounds too close to the DS procedure.  At least it sounds too close for my comfort.  And if it's not common, you may be hard pressed to find a surgeon willing to do it.

Good luck!

I was going through years of tests for lupus. Because of not having that diagnosis I guess no one opossed me. I also live where it is still new to be okay with WLS but I got most to be okay with me wanting it. I had the RNY done laproscopically. Since I have not suffered from any complications or any problems that I had before. It's amazing truly. I don't have any health concerns or problems other than some skin issues time to time. That can only help me get skin removal I suppose. I have lost over 160 lbs and going still to this day. It will soon be my 2 yr celebration!!! I encourage the RNy and have seen too many succeed to it compared to the band. I know the band is more a marketing tool and most surgeons know it and can't say how they truly feel with out feer of being sued. I would say that if you feel WLS is best, give a shot! I have so much to be thankful for now, truly.