Am I being silly?

For what it's worth my dietitian told me the same thing after I told her my choice of VSG. Said RNY would get me to my goal and I would be more successful with it. My surgeon was happy with RNY or VSG and left it entirely up to me. I'm 5 months out and already in the 180's. If you would have told me I would be here last year I wouldn't have believed it. 

VSG is just as good as RNY, and for me it's even better. That's why I chose this route. Trust yourself. 

My advice is ask questions and then research the validity of the answers you get.  There is a reason getting a "second opinion" is common in the medical profession.  If you are being pushed into RNY for invalid reasons or reasons that are not valid for your situation find a new surgeon.

 When I started out I wanted the lap band.  My surgeon recommended either the VSG or Gastric Bypass.  I asked why, researched it and agreed.  When I asked for a recommendation as to which one, he basically told me I couldn't go wrong with either.  I was 405lbs before surgery.

With your high weight, odds aren't on your side to getting to goal as easily with VSG as they would be with RNY, which is why she is recommending it.  Another procedure to consider is the duodenal switch, which has the VSG stomach, so you can take NSAIDS.  The DS and the RNY give you metabolic change where the VSG is set on restriction only - which is great for many people, but others not so much.  There are only a few surgeons in CA who do the DS, and they are very highly respected in their field.  It also yields the highest rate of weight loss and lowest rate of regain long-term.  We have many VSG patients getting revisions to it.

The DS and the RNY give you metabolic change where the VSG is set on restriction only

I'm new and I don't want to step on any toes, but this is actually not correct. According to the latest research, VSG is indeed a metabolic procedure as much as RNY and DS are.  (I believe Dr. Randy Seeley from the University of Cincinnati, a researcher and not a clinician, is the one who published those findings a couple of years ago.) I don't know if that helps the OP at all or just confuses things, just wanted to share the info.

I am in a similar situation.  I was approved for the lapband in 2006, but backed out of it.  No regrets.  Now my insurance is a bit more liberal and I don't have to go to a center of excellence (all 2 hours away), I can go to a local hospital that has been doing bariatrics for 20 years.  They have a pretty great support system, and active support groups.  I get a much better feeling about success here.  BUT... they haven't done a lot of VSG, and I believe strongly this is the best procedure for me.  The new people (>2 years out) in the groups are split between RNY and Lapband.  I still think this practice is the best for me, but am leary of a surgeon without a solid VSG record.  Luckily, a new surgeon is transferring to this practice, who used to be the VSG guy at a CFE,  and I may switch to him. Even if I can't, I will probably go forward with this surgical group due to their support program and record of success.

I too have autoimmune issues, and while I don't take NSAIDS daily, I can't be confident in anything that will eliminate them.  

Best wishes,

Tracy

Can you share the study, please?  I"m curious of the findings since there is nothing more done than make the stomach smaller.  That being said (and I'm sure the VSG to DS revision patients can agree with) is that the OP needs to understand the benefits of restriction/malabsorption benefits vs. just restriction.

Sure - the study is published here in Nature magazine. But it costs a subscription to read more than the summary. (From the abstract: "Here we demonstrate that the therapeutic value of VSG does not result from mechanical restriction imposed by a smaller stomach. Rather, VSG is associated with increased circulating bile acids, and associated changes to gut microbial communities.")  Here's a good article where they interview Dr. Seely and he talks about the research in National Geographic.

I agree with you that is VERY important for the OP (and everyone!) to understand the mechanics and physical affects of each surgery thoroughly before they decide what's best for them. I think sometimes doctors just want to prescribe and not explain, but we as patients really shouldn't accept that. The OP is right to question and push bac****il she feels comfortable with her own decision.

Yes, the 'lead' surgeon at the clinic where I went also tried to get me to go with RNY.  I ended telling him that I didn't want my intestines rearranged, and that if he was saying he wouldn't do the VSG, then I wasn't going to have WLS.  I agree with everyone else - find another surgeon - one who is comfortable doing the VSG (ask them how many they have done! - It's a fair question.)  Sometimes drs are wrong; even you trust them.  You know your body best - after all you've had it since you were born.  They, on the other hand, just met you and your body.  IJS..............

Are you being silly? Yes, and no.

It's not at ALL silly to think you're the best person to decide which form of WLS is best for YOU. After all, you're the one who will spend the REST OF YOUR LIFE dealing with the consequences of this decision.

It IS rather silly to think this is THE surgeon for you, when she wants to do a procedure that you don't want. You've been to four seminars---go to four more if you need to, in order to find the right surgeon for YOU.

That said, I also encourage you to research the Duodenal Switch. The DS has the very best long-term, maintained weight-loss stats for patients of any size, period. For those of us with a BMI greater than 50, this is even more true. However, the DS achieves this by extensively rearranging your insides, and taking a handful of pills multiple times a day is MANDATORY. It's not about not looking like you're at death's door, it's about not BEING at death's door. (And for what it's worth, most people who get the VSG also need to take vitamins and supplements. In fact, most people who get no surgery at all need to be taking some.)

The DS has the same stomach as the VSG, so you'd still be able to take NSAIDs. Believe me, the older *I* get, the more I appreciate this. I take calcium 3 times a day, a multi twice a day, and A, D, and K once a day. For ME, it's no big deal---it quickly became a habit and I don't really even think about it any more. It's a lot easier for me to 'do' something, like take my pills, than it is for me to 'not do' something---like resisting tasty foods all day every day. I always did suck at dieting. (*grin*)

I have not had surgery yet but maybe if you get recommendations from your Lupus doctor and RA doctor supporting your decision she will see where you are coming from. I mean I know RNY is the gold standard for WLS but it seems to me you have a legitimate reason for wanting the VSG.