Yes, yet another discussion about sleeve vs. RNY
I would like some feedback or comments about long term observations on the Sleeve vs. the RNY. We have a family member that got RNY'd about 5 years ago. Now this poor man is back up to a very unhealthy weight. When I took classes at Kaiser word about the RNY was that it took away a hunger recognizing mechanism in the stomach, but that in the sleeve this mechanism remains. Is there any truth to this, anyone know? Is this why people ar liking the sleeve better, because of the long term success?
Thank you.
Thank you.
I may have read your comments wrong but from what you wrote you have it backwards. The sleeve is the one that takes most of the hunger hormone ghrenlin and I believe that is intact with the RNY.
People tend to like thee sleeve better because it is a quicker recovery, less or no dumping and fewer malnutrition and malabsorption issues that occur w/other forms of WLS. It is also the cheapest of them all for self-pays like myself.
Regardless of which one you choose, they are all tools and will work if you work them. It is sad to hear those who gain all their weight and more back or who do not maintain a healthy weight. Yet, that is the reality. If you don't keep track of what you eat and exercise, the same thing will happen.
It is a wonderful tool if you let it be.
People tend to like thee sleeve better because it is a quicker recovery, less or no dumping and fewer malnutrition and malabsorption issues that occur w/other forms of WLS. It is also the cheapest of them all for self-pays like myself.
Regardless of which one you choose, they are all tools and will work if you work them. It is sad to hear those who gain all their weight and more back or who do not maintain a healthy weight. Yet, that is the reality. If you don't keep track of what you eat and exercise, the same thing will happen.
It is a wonderful tool if you let it be.
HW: 550+ SW: 502 CW: 342.4 SDt: 9/20/11
"I can do all things through Christ which strengtheneth me."--Philippians 4:13, KJV
what you are referring to is called grenlin and it is actually removed during the sleeve. If it is done properly it doesnt really matter if you feel hungry or not because your sleeve is not going to let you eat very much anyways. I had the sleeve 3 months ago and I am down 70 pounds. Its the best thing I have ever done for myself. I know several people that have had the RNY and have also put the weight back on because the restriction is not as good and the malabsortion is only good for the first 2 years. This is just what I have heard from the people I know that have had it done!!! Good luck with whatever you decide but I assure you, you wouldnt regret the sleeve.
HW:359 June 1st: 299.5 SW: 276.5
That information sounds backwards. Since the fundus is completely removed from the body with VSG vs. the stomach remaining intact (just stapled off) with the RNY, I'm not sure where that information is coming from.
However, here is a study on VSG vs. RNY for ghrelin plasma levels in patients with these 2 particular procedures. Ghrelin is the hunger hormone. I am still never physically hungry, and I'm 28 months post VSG.
I can tell you with my band, which is a pouch surgery also, I was always hungry, like stark-raving MAD hungry as soon as that food dropped out of my pouch. I realize the pouch with the band is different than the pouch/stoma combination with the RNY, but still I was starving with that huge stomach intact still producing ghrelin.
I realize this is NOT a huge number of participants in this particular study, but it's what I have bookmarked for reference:
http://www.ncbi.nlm.nih.gov/pubmed/18376181?ordinalpos=12&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum
However, here is a study on VSG vs. RNY for ghrelin plasma levels in patients with these 2 particular procedures. Ghrelin is the hunger hormone. I am still never physically hungry, and I'm 28 months post VSG.
I can tell you with my band, which is a pouch surgery also, I was always hungry, like stark-raving MAD hungry as soon as that food dropped out of my pouch. I realize the pouch with the band is different than the pouch/stoma combination with the RNY, but still I was starving with that huge stomach intact still producing ghrelin.
I realize this is NOT a huge number of participants in this particular study, but it's what I have bookmarked for reference:
http://www.ncbi.nlm.nih.gov/pubmed/18376181?ordinalpos=12&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum
Band to VSG revision: June 3, 2009
SW 270lbs GW 150lbs CW Losing Pregancy Weight Maintenance goal W 125-130lbs
SW 270lbs GW 150lbs CW Losing Pregancy Weight Maintenance goal W 125-130lbs
On October 3, 2011 at 6:07 AM Pacific Time, kimberly_castillo wrote:
thanks everyone i am conflicting back and forth between the sleeve and rny i am 99.9 % sure now after reading these posts that i want the sleeve done what i already signed up for. my surgery is set for nov 10 and i am sooo looking forward to starting my new journey..... thanks again.
This is my standard reply when this question pops up every couple of days. I won't try to sway anyone one way or another, but I'll give you my reasons for choosing VSG over RNY for my revision from the band. You can also check out the revision, failure, and food issue forums on here to get an idea of some long term RNY patients. For me, it was never an option. The cons outweighed the pros.
The VSG was my 2nd, and final WLS. I could have easily had RNY, but I fought to have VSG as my revision from the band. Some factors I considered in deciding on VSG. The pouch that RNY offers is similar to the pouch with the band. Least to say, a pouch sucks, I love having a normal tummy, just less capacity and still fully functioning.
1) No blind stomach left behind that can be difficult to scope yet can still get ulcers and cancer.
2) 2 years max on calorie/carb/sugar malabsorption, but a lifetime of vitamin/nutrient malabsorption. This process is called adaptation, and it happens with intestinal bypass surgeries.
3) I had a pouch with the band, and it sucked. I'm pretty fond of my pyloric valve and the sleeve let me keep it. I love having a normal functioning stomach, just smaller in capacity.
4) Regain stats and #of RNY patients seeking revision truly scared the poop out of me
5) I have too many friends in real life that struggle with vitamin deficiencies post-RNY, and most of them either never got to goal, or have gained back a significant amount of their weight.
6) The long term complications with RNY were too numerous for my comfort level. Pouch or stoma dilation, strictures, vitamin/nutrient deficiencies, ulcers,
7) I researched gastrectomies that had been performed for stomach cancer and ulcer patients, and found comfort in the long term results and minimal complications of patients that had lost most or all of their stomachs had dealt with over several years.
8) I was a volume eater, and knew a restrictive only procedure would work for me. That was my thought process when I got the band, and I thought I could beat the odds on complications. Sadly, the band only lasted 8 months before I had to revise.
9) I did not want to have food or medication restrictions. I chose WLS to have a "normal" life, and I think it's normal to eat a couple of cookies. With RNY, I wasn't willing to go through the possibility of dumping if I wanted to have a couple of cookies, or a slice of cake on occasion. The big scare for me is medication restrictions for life. NSAIDS and steroids are a NO GO for life with a RNY pouch. I realize that I may never be diagnosed with a condition or disease that requires steroid use, but it is possible. I want the best long term results with the least amount of complications. Malabsorption is not anything to play with in my mind, and I was not willing to take that risk.
I lost all my weight in my ticker with the exception of 7lbs with the sleeve, and I did it in 10.5 months. The 115lbs fell off the first 6.5 months, and then the rest I lost as I was getting into maintenance over another 4 months.. It's been a fabulous journey, and I'm easily maintaining with zero issues for nearly a year at this point. I want to add that every WLS regardless of your choice will require discipline. Only a percentage of RNY patients dump on sugar/fat, pouches and stomas stretch, then you have the medication restrictions. I'm not trying to convince you, but these were my concerns when I knew I had to revise from the band. I started at 263 the day of my revision and today I weigh 127lbs. I bounce on the scale 125-130lbs any given week, and I couldn't be more ecstatic!
Best wishes in your research!
P.S. I wrote this before pregnancy. And, just as an update, I'm 8.5 months pregnant and thriving. I have zero issues consuming enough calories/protein/carbs to support my body and another developing human. My labs have remained stellar throughout the pregnancy, and life is pretty good. I am over 2 years out at this point, and couldn't be happier with my decision to have VSG over RNY for my revision. It's been an amazing journey.
P.S.S.
Since the pregnancy, I have been diagnosed with a genetic clotting disorder and the ONLY treatment (zero cure) is a daily aspirin therapy. With VSG, this treatment is possible, if I would have gone with RNY my doctors (surgeon, 2 ob's, PCM) are unsure how this condition would have been treated especially during the pregnancy. Grant it, I only take a baby aspirin every day of my life, but it is an NSAID. Least to say, when my high risk ob found out I had a partial gastrectomy and NOT RNY, he was elated because there really is zero other option for treatment at this point, and the aspirin therapy is working well with my platelets and if all goes as planned, I will be able to have an epidural for my c-section instead of having general anesthesia. Maybe a small issue to some, but being awake for the birth of my daughter is top priority for me.
As a very recent addition; as of 10 days ago, I was advised I would have to be given a steroid(dexamethasone or prednisone) to help get my platelet count up as they have dropped. If I would have had the RNY, this would NOT be possible, and pretty much general anesthesia would be required for the csection. We're looking at other options for delivery such as a spinal block instead of a full epidural, but the doctors are positive the steroids will get my numbers up. At any rate, if I would have chosen RNY, I would surely not be able to have steroids. Looking back, I can't tell you how grateful I am that I was able to choose VSG.
The VSG was my 2nd, and final WLS. I could have easily had RNY, but I fought to have VSG as my revision from the band. Some factors I considered in deciding on VSG. The pouch that RNY offers is similar to the pouch with the band. Least to say, a pouch sucks, I love having a normal tummy, just less capacity and still fully functioning.
1) No blind stomach left behind that can be difficult to scope yet can still get ulcers and cancer.
2) 2 years max on calorie/carb/sugar malabsorption, but a lifetime of vitamin/nutrient malabsorption. This process is called adaptation, and it happens with intestinal bypass surgeries.
3) I had a pouch with the band, and it sucked. I'm pretty fond of my pyloric valve and the sleeve let me keep it. I love having a normal functioning stomach, just smaller in capacity.
4) Regain stats and #of RNY patients seeking revision truly scared the poop out of me
5) I have too many friends in real life that struggle with vitamin deficiencies post-RNY, and most of them either never got to goal, or have gained back a significant amount of their weight.
6) The long term complications with RNY were too numerous for my comfort level. Pouch or stoma dilation, strictures, vitamin/nutrient deficiencies, ulcers,
7) I researched gastrectomies that had been performed for stomach cancer and ulcer patients, and found comfort in the long term results and minimal complications of patients that had lost most or all of their stomachs had dealt with over several years.
8) I was a volume eater, and knew a restrictive only procedure would work for me. That was my thought process when I got the band, and I thought I could beat the odds on complications. Sadly, the band only lasted 8 months before I had to revise.
9) I did not want to have food or medication restrictions. I chose WLS to have a "normal" life, and I think it's normal to eat a couple of cookies. With RNY, I wasn't willing to go through the possibility of dumping if I wanted to have a couple of cookies, or a slice of cake on occasion. The big scare for me is medication restrictions for life. NSAIDS and steroids are a NO GO for life with a RNY pouch. I realize that I may never be diagnosed with a condition or disease that requires steroid use, but it is possible. I want the best long term results with the least amount of complications. Malabsorption is not anything to play with in my mind, and I was not willing to take that risk.
I lost all my weight in my ticker with the exception of 7lbs with the sleeve, and I did it in 10.5 months. The 115lbs fell off the first 6.5 months, and then the rest I lost as I was getting into maintenance over another 4 months.. It's been a fabulous journey, and I'm easily maintaining with zero issues for nearly a year at this point. I want to add that every WLS regardless of your choice will require discipline. Only a percentage of RNY patients dump on sugar/fat, pouches and stomas stretch, then you have the medication restrictions. I'm not trying to convince you, but these were my concerns when I knew I had to revise from the band. I started at 263 the day of my revision and today I weigh 127lbs. I bounce on the scale 125-130lbs any given week, and I couldn't be more ecstatic!
Best wishes in your research!
P.S. I wrote this before pregnancy. And, just as an update, I'm 8.5 months pregnant and thriving. I have zero issues consuming enough calories/protein/carbs to support my body and another developing human. My labs have remained stellar throughout the pregnancy, and life is pretty good. I am over 2 years out at this point, and couldn't be happier with my decision to have VSG over RNY for my revision. It's been an amazing journey.
P.S.S.
Since the pregnancy, I have been diagnosed with a genetic clotting disorder and the ONLY treatment (zero cure) is a daily aspirin therapy. With VSG, this treatment is possible, if I would have gone with RNY my doctors (surgeon, 2 ob's, PCM) are unsure how this condition would have been treated especially during the pregnancy. Grant it, I only take a baby aspirin every day of my life, but it is an NSAID. Least to say, when my high risk ob found out I had a partial gastrectomy and NOT RNY, he was elated because there really is zero other option for treatment at this point, and the aspirin therapy is working well with my platelets and if all goes as planned, I will be able to have an epidural for my c-section instead of having general anesthesia. Maybe a small issue to some, but being awake for the birth of my daughter is top priority for me.
As a very recent addition; as of 10 days ago, I was advised I would have to be given a steroid(dexamethasone or prednisone) to help get my platelet count up as they have dropped. If I would have had the RNY, this would NOT be possible, and pretty much general anesthesia would be required for the csection. We're looking at other options for delivery such as a spinal block instead of a full epidural, but the doctors are positive the steroids will get my numbers up. At any rate, if I would have chosen RNY, I would surely not be able to have steroids. Looking back, I can't tell you how grateful I am that I was able to choose VSG.
Band to VSG revision: June 3, 2009
SW 270lbs GW 150lbs CW Losing Pregancy Weight Maintenance goal W 125-130lbs
SW 270lbs GW 150lbs CW Losing Pregancy Weight Maintenance goal W 125-130lbs
Wow! Thank you for all your research and thourough explanation! Your information is hands down top notch! Really, thank you so much for the education. I am anxious to keep reading your posts to see how you do. Good luck with the birth of your little girl.
I too am a volume eater, I pray the sleeve will help me too, for ever more.
I too am a volume eater, I pray the sleeve will help me too, for ever more.
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