Thinking of switching to the sleeve instead of bypass....ADVICE PLEASE!

NHPOD9
on 12/8/12 8:25 pm

I really wanted the sleeve, but it was not an option for me because of GERD. 

While I don't regret RNY, I do worry about the future and NSAID use.  Tylenol is not really effective and the dangers of overusing that drug scare me.  

~Jen
RNY, 8/1/2011
HW: 348          SW: 306          CW:-fighting regain
    GW: 140


He who endures, conquers. ~Persius

Cleopatra_Nik
on 12/8/12 9:01 pm, edited 12/8/12 9:01 pm - Baltimore, MD

First I have to say, I think you might be wrong about dumping. I always thought dumping had to do with the opening of your stomach to your intestines and your STOMACH (not your intestines) being unable to break down those sugars. If that is the case the big difference between RNY and VSG (I believe...but am not 100%) is that we get the same section of the stomach as a pouch (or Sleeve shape for you guys) BUT with the sleeve the remnant stomach has been completely removed (it's not needed because there is no intestinal rerouting) whereas with RNY it remains to create the digestive acids we need because we don't have access to all our intestines.

So having said that...I actually think you CAN dump with the Sleeve.

But to answer your question, no and here's why.

I NEEDED dumping syndrome to be more of a "sure thing". Why? Because my food addicted brain does not understand "you shouldn't." It does understand "you can't." It understands punishment and pain and when I get that I don't do whatever I got punished for. So I knew that in order to change my relationship with food I had to approach this thing in a way that I could understand and respond to.

Your mileage may vary. I would just encourage you to be honest with yourself as you make this decision. Malabsorption SOUNDS scary but its not really. With either surgery you're going to have to take vitamins for the rest of your life. And frankly, having heard the head nutritionist at Bariatric Advantage Vitamins speak, they really aren't sure HOW to treat Sleeve patients vitamin wise. The bariatric community thus far has treated them like bypass patients to ensure they get the right level of vitamins so I think you'd even be taking the same vitamins.

So...if you feel like you can prioritize your eating properly (protein first, complex carbs, moderate fats and treats) and keep up with the other things you'll have to do to lose weight, I think the Sleeve is a good solid option. If you, like me, have a hard time controlling yourself, you might give the bypass another look. While it isn't guaranteed you'll dump (I think only something like 30 or 40% of us do) the possibility alone might be worth it to get you out of the habits that got you here in the first place.

I think a pro's/con's list is in order. :)

RNY Gastric Bypass 1-8-08 350/327/200 (HW/SW/CW). I spend most of my time playing with my food over at Bariatric Foodie - check me out!

Cicerogirl, The PhD
Version

on 12/9/12 3:04 am - OH
Hey, Nik, the problem that causes dumping is that 1) we no longer have a pyloric valve to control the emptying of food into the intestine AND 2) the lower portion of the intestine expects sugars to be partially digested by the upper portion of the lower intestine, which is what we have bypassed. Since the sleeve doesn't involve the bypass (and still has the pyloric valve in place) there is no dumping. Even DSers, with a different type of bypass but with the pyloric valve, don't dump.

Lora

14 years out; 190 pounds lost, 165 pound loss maintained

You don't drown by falling in the water. You drown by staying there.

(deactivated member)
on 12/8/12 11:11 pm

I had the sleeve in 2009.  Lost 70 pounds in the first six months, then maintained for six months, then had a hysterectomy followed by bunion surgery (and three months in a boot).  Slow regain started.  Then I broke my foot.  More regain.  I'm up 25 pounds now.  (It was 30; I've been losing recently.) But my GERD is horrible, awful, terrible!  So now I'm looking at RnY to 'cure' the GERD.

I had GERD pre-sleeve, and I love my sleeve.  I would do the sleeve again if I didn't have pre-existing GERD.  Knowing how bad the GERD is now vs. how it was pre-sleeve, I would choose the RnY.  Having a second surgery is not happy! (I find out for sure on the 18th.)

As far as NSAIDs,  my surgeon told me NSAIDs were a no-no with the sleeve too.

Robin

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