Postponed my surgery

on 4/28/19 9:38 pm
RNY on 05/01/19

Its been 2 weeks since I saw the surgeon to sign my consent form. Surgery was scheduled for the end of next week. I was surprised during the consult when Dr informed me he wasn't sure my liver would be able to sustain the RNY procedure, and he might have to do the sleeve instead. After driving home, I had serious second thoughts. As I understood it, the sleeve doesn't offer the same advantages as RNY with regard to decreased hunger and "curing" Diabetes type II.

I had already started Optifast, had hotel booked, family support in place etc only to second guess my decision. I have up to 1 year to reschedule - but I had carefully planned the timing of the surgery with regard to work schedule, weather etc etc. I'm disappointed, sad and unsure. I am going to phone next week to schedule another appointment with surgeon to ensure I understand clearly.

Has anyone else had this type of experience?

on 4/29/19 7:45 am

From what I can ascertain, your surgery is not postponed, but rather to continue but with the sleeve rather than the RNY? Is that correct? I know during the various appointments I have had, they clearly indicated that there are occasions when the surgeons will determine one surgery is preferable to the other, based on the patient's medical history and issues (and sometimes patient preference as I know several people who opted for the sleeve versus the RNY). At my nutrition appointment a few weeks ago, the nutritionist indicated that sometimes what happens is they do one surgery, once that is done and over with and the patient progresses losing weight etc, then the other one is done. So if the surgeon is saying he feels your health won't allow for the RNY at this juncture, it most likely doesn't mean "never" - and I would seriously listen to his expertise. My sister had the sleeve and lost 50 lbs in six months! My understanding is the sleeve also suppresses hunger hormones to a certain extent; and the smaller pouch makes it uncomfortable to eat big portions.As a type 2 diabetic myself, I know that even relatively small losses can impact the numbers - for the better. So it is of course your choice and a good idea to revisit with the surgeon, but this doesn't sound like a bad first step. By the time you've lost some weight (due to sleeve working)- you can perhaps look down the road at the RNY - something to discuss with your surgeon.

on 4/29/19 9:31 am

My surgeon said the same thing. I made it clear I wanted RNY and he said that he would see when he got in there whether he could do RNY safetly. I signed a consent for the sleeve with possible RNY. My BMI was 63. They generally don't like to do RNY in my region over a BMI of 60. I did optifast for 1 month and I guess I was able to shrink my liver enough because I woke up with a RNY. He said it was tricky but he did it and I was thrilled. That aside, I would have still did the sleeve as he explained that you can revised to RNY if you don't get the results with sleeve. However, many people have been very successful with the sleeve also and I was going for it either way. I wish you all the best whatever you decide.

Referral: March 2017, Orientation: June 2017, Nurse, Social Worker, Nutritionist, Pharmacist: Dec 2017, Physiotherapist and f/u with Nurse: Feb 2018, Meet Dr. Lindsay: Feb 2018, Pre-Op Feb 26, 2018, Start Optifast (4 weeks): Feb 27, 2018, SURGERY: MARCH 27/18 at St. Joseph's in Toronto with Dr. Lindsay. Height 5'2," 49 Years old, Hw: 365, Pre-Op Weight (start of Opti 355), SW 334 CW 175. Weight Loss: Pre-op -19, M1 -23, M2 -18, M3-18, M4-14, M5-14 M6-10, M7-14 M8-8, M9-14 M10-5, M11-10 M12-0, M13 -3, M14 -6, M15 -7

Kath L
on 5/6/19 9:58 am

I feel you should trust the surgeon's judgement and do what they recommend. They are educated and have the experience. Either way, you still need to do the work after surgery.

I haven't had surgery yet, but it was discussed at the orientation that it is up to the surgeon as to what type of surgery they decided is best for you.

Wishing you luck.

Referral: Feb 14/17; Processed: Apr 28/17; Hamilton Orientation: July 24/17; Pre-Nutrition: Oct 27/17; Re-Do Hamilton Orientation: Apr 29/19; Pre-Nutrition: May 17/19; Nurse: May 29/19; Blood work: Aug 2/19; EKG: Aug 1/19; Allergist: Aug 15/19; Abdominal Ultrasound: Sep 4/19; Dietician: Sept 9/19; Internist Dr. Taboni: Oct 10/19; Social Work: Nov 06/19; Endoscopy Consult: Nov 08/19; Gastroscopy: Nov 21/19; Meet Dr. Gmora: Dec 4/19 Pre-Op and Surgery Class: Jan 09/20 Surgery: Jan 13/20 OMG they moved it up to Jan 06/20

on 5/23/19 6:09 am
RNY on 01/16/18

The surgeries are definitely different, there is no question.

I actually wanted a sleeve but the surgeon said no way, RNY was the way to go for me.

Although different surgeries, I am firm believer in you get out of it, what you are prepared to put into it. The surgery is not a magic bullet. It is just a tool.

The sleeve will still help you to eat less and you still have to adhere to a diet that is consistent with weight loss just like with RNY. It's going to be work no matter which surgery you have. In fact, it's going to be work for the rest of our lives.

The choice is ours.

Here's the other thing, I know people who have had the sleeve and then once they lost weight they had a second surgery to revise to an RNY. So, RNY is still possible, just not right now.

Discuss with your surgeon. Ask the hard questions. You may be surprised.

Referral - May 31/17; Orientation - June 15/17; First Appt Nurse - June 26/17; Bloodwork and ECG - June 27/17; Sleep Study - July 5/17; Dietician Appt - July 10/17; Counsellor Appt - July 10/17; Abdominal Ultrasound - July 10/17: Endoscopy/Colonoscopy - July 25/17; Second Dietician Appt - September 14/17; Internist Appt - October 2/17; Meet the Surgeon - November 21/17; Pre Surgery Nutrition Class - January 12/18; Surgery - January 16/18

on 6/1/19 8:48 pm
RNY on 05/01/19

Thanks to everyone *****plied. I saw the surgeon this past week & we have re-booked the surgery for September.

In my particular case, it is uncertain if my liver can withstand the RNY, and won't know until they see the liver. NAFLD - didn't appreciate how dangerous this can be. Gastroenterologist told me he often has patients talk about being afraid/worried about having gastric bypass, but not one has yet expressed the same level of fear in regard to health consequences of NAFLD.

I balked at the May surgery b/c up until the appointment to sign the consent I had been totally focused on RNY being a "cure" for any hunger issues and I had really been counting on the appetite suppression piece. As the surgeon correctly pointed out, both procedures are tools to help me manage a chronic illness [ just as a person would need tools to manage other chronic conditions like diabetes, parkinsons etc.]. It has helped immensely for me to readjust my thinking in this regard. Obesity is a chronic condition that cannot be cured, but it can be managed using various tools.

I'm focused on high protein eating, exercise and weight reduction to help my liver along before the surgery. I've purchased a FitBit and an app to help me track eating. I'm journaling and trying to push myself out of my comfort zone to begin swimming again.

White Dove
on 6/2/19 7:50 am

One thing I recommend to people starting this journey is to purchase and use a Smart Scale that pairs with your fitness device. I have found that having access to the additional metrics gives me very valuable information.

When there is a gain or loss, I also look at whether there is gain or loss of water weight, bone mass, or body fat. I used to guess a lot. I would see the scale go up and think about how much sodium I had consumed. I was surprised to see that often the water weight is less than the day before.

By knowing exactly what is going on with my weight, I can make more educated adjustments quickly and also know whether or not to worry about changes on the scale.

Make sure that your new scale measures body fa****er percent, muscle and bone mass. Expect to pay $100 - $150 for an investment that will serve you for many years. There are less expensive scales available, but they do not have the features that will make a difference to you.

Monitoring those numbers along with my weight has helped me immensely.

Real life begins where your comfort zone ends