WTH?

Went to my doctor today.  I have been on my supervised diet for 6 months now.  I have been on the road to RNY and now he wants to talk about the sleeve.. WTH?  Really?

So now he says that he thinks the sleeve would be better for me. Because i am still young enough that if i don't succeed with the sleeve i can still have bypass.. I have the lap band so it will be a revision.  i just dont understand.  I have cried and cried..

What do I do?  I really haven't even looked at the sleeve.  I could tell you everything about bypass.  

so do i go with the sleeve and then later have bypass..Is that the standard?

I am 5'1 278 pounds.  Sleep adnea, bad knees, asthma and 50 years old.

So confused..

Sugery date is 12/17/13  which one, I have no freaking idea..

No, you don't go with the sleeve and later have bypass.  No, that's not standard.  You have the surgery you believe will be  most effective for you, so that you don't need another down the road.

Oh my gosh, YES to everything she said!

If you wanted the sleeve, that would be one thing...but unless he had some strong medical reason against RNY for you then I'd let him know you appreciate his insights, but that you are going to continue down the path you started with RNY. 

Hugs--I can tell you are really upset and I hope you're calm and feeling better by the end of the day. 

That's really strange rationale for his recommendation. . . so when the sleeve fails, you could have another (3rd) surgery???  I don't understand that at all. 

It's a personal decision.  I would not want to go from lapband to sleeve then to RNY....it makes no sense at all.  The sleeve would better be revised to the DS since it's the first part of the DS.

Do you believe a restriction only surgery will be enough?  Yes, the RNY malabsorption isn't forever but it does give you (general you) a jump start for 12-18 months then you should have learned enough to continue following the rules and hopefully not see any significant regain.

I also don't understand why he would want to change or discuss a different surgery 6 months into it.  Did y'all not discuss your options before this began?  Ultimately, it's up to you which surgery you proceed with unless there is a medical reason why the RNY or sleeve for that matter wouldn't be a good option.

I definitely wouldn't want to go into a surgery thinking if this doesn't work I'll revise to something else.  And, insurances are getting tougher on approving WLS and the ONE time limit is being added to more and more insurance policies. 

OK, so just alittle background about myself - I had RNY surgery with silastic banding done in 2006 - I (5'4") have been successful! From 265 to 160 lbs and have basically maintained that loss.  My daughter (5'3.5' LOL) (25 y/o) had Sleeve done in 2009 went from 240 to 130 has maintained that even after 2 births.  Would I change to a sleeve?  you bet.  However every individual is different.  Please don't discount the idea.  Look at the procedure, restrictions, etc... and make an informed choice!  You still have time!  READ READ and learn more about this option.

PSS I just realized I am having a surgery anniversary... Yea Me!

If the insurance company pays, then he will get paid for two operations instead of one. 

There may be other reasons though and maybe he thinks restriction only is enough for you.How did you do with the lapband? 

My personal belief is that people are lucky to take off 100 pounds with RNY and maintain about 80 pounds of that longterm.  People lose the least with lapband and less with sleeve than with RNY.

DS has the longest malabsorption and best record for maintaining, but also the most risks of complications.  If I were you, I would just get the RNY.  Many insurance companies are adapting the policy of one weight loss surgery per lifetime. 

You could end up having to pay for the RNY out of pocket.

Have you lost well during the 6 month supervised diet?  Maybe he realized you only need restriction for long term success.  RNY is a major re-routing of your insides.....and you cannot take NSAIDS forever, and there are other issues such as vitamin deficiency and RH-Why don't you ask for specific reasons as to WHY the doctor asked you to consider this?  It may be a very viable option that deserves some thought.

With a BMI of over 50, and at 50 years old, I would suggest that you need ONE surgery with a malabsorption factor - the DS would be preferable, but an RNY over a sleeve would be my choice.

It's your body, but why on earth would you have a surgery that sets you up to have yet another revision?   Tell him what you want and if he can't come up with a reason why you can't have it, then that's the decision!

My surgeon, who does a LOT of revisions from lap band, will not do band to sleeve revisions. She found that a large percentage of those with the band have an inactive vagus nerve.  In order for the sleeve to work the vagus nerve has to be functional. if you get the sleeve and are one of the percentage of people with an inactive vagus nerve you have a miserable recovery.  You are literally sick every time you eat for 1-2 months.  There is not way of knowing beforehand if you will have this problem.  My doctor will only revise from band to sleeve in two separate surgeries, three months apart.