Newbie: Sleeve vs Bypass

boomerkae

Hi everyone!
I'm Kim - and next Monday I have my final insurance mandated diet appointment. From the day of my first meeting with the surgeion to start this process, I've lost 21 lbs (about 3.5 months). I currently weigh 261.

As part of the normal pre-work, I was tested for apnea, and while I was not diagnosed with it, I was diagnosed with narcolepsy. I am on medications that guess what - can cause weight loss.

I've been doing just about everything I should diet wise, staying in calorie range all but maybe 3 days out of the last 2 months. I've been dropping weight since the meds. If I'm not careful this week - I may no longer qualify for surgery.

I have a decision to make - sleeve or bypass. I'm leaning toward sleeve, as I get it's a tool - I think my track record these last few months demonstrate that I have to make changes and can. I've been overweight my entire life- and have only lost weight significantly twice, and both required insane exercise (3+ hours a day). I'm older now and with a FT job and 2 young kids, I can't do it. My father and sister have both had bypass.

So...what made you choose sleeve over bypass? I like many options for the sleeve, but wonder if I should just go for the gusto with bypass. Your thoughts?

I've been blogging about my experience at http://kimegetshealthy.blogspot.com/ . Take a look if you'd like!
Thanks!
Kim

MistyHiker

For me this was how I made my decision. And it took me 6 months to make my decision.

The Bypass - later down the line there could still be issues due to the way the surgery is done.

The Sleeve - Once surgery is done, all organs are still where they belong, you just have a smaller stomach. Once stomach is fully healed from surgery there are zero to no complications further down the line.

That's just me.

juneaubug

I chose the sleeve over bypass because I've never liked the idea of the bypass (malabsorption) portion of the bypass surgery. I was worried I would be more prone to vitamin/nutrient deficiencies down the line.

I did ask my surgeon and the other doctors in that office whether they would recommend one over the other for me. They really wouldn't. What I did get from them was that initial weight loss is faster with bypass, but at some point it evens out and is the same as the sleeve. (averages, of course).

They also said that if I was diabetic, or a sugar fiend, they would recommend bypass over the sleeve as they see an immediate reversal of diabetes with bypass (it reverses with the sleeve as well, but takes longer). As far as the sugar fiend goes, bypass patients often experience dumping syndrome which they consider an additional tool (as opposed to a side effect) that helps you stay off really sweet things. I personally don't crave a lot of sweets - I've always been more of a pizza, chips, cheese and crackers kind of addict.

I don't know that there is a wrong answer - you have to figure out which one works best for you. I was sleeved October 2013 and have been very happy with it. I was 317 when I started the pre-op diet (2 weeks), and 302 on the date of surgery. I'm down to 207 now. I still have a month to go and am hoping to be under 200 by my one year appointment (although I seem to be in a bit of a stall right now!).

Best of luck to you!!

SimplySusan63

I agree with the comments above. I also chose the sleeve because of the fact there are fewer related complications. Plus the possibility of life long mal-absorption, as well as the higher risks, caused me to choose the sleeve. I felt it was more middle of the road, less severe than bypass.

Having said that, I truly believe you're the only one who can make that decision. What are you willing to live with?

Good luck and keep in touch.

loriloftness

I am choosing the sleeve because 1) I don't want to have my innards rearranged and 2) because of the malabsorption issue. I already have problems with my body not processing nutrients (mostly iron) effectively and have had to be on/off iron for a decade. The sleeve allows my body to process the nutrients from food just like it would prior to the surgery-- I just will be eating less food. I know I will still take supplements but I like the idea that I'm still getting the most nutrition-wise from my food that I can.

Really, I think this is an issue you need to discuss with your doctor and to think about yourself to see what makes the most sense for your life and your physical condition. I don't think the answer is the same for everyone.

bethkallastrask

I had sleeve done about 8 months ago, have lost 82 pounds. I have another 10-15 to hit my goal. I couldn't have had bypass since I had prior pelvic radiation due to cancer treatment, however I was leaning towards sleeve anyways. I didn't want to deal with the worry of dumping and deal with the vitamin issues either.

garber6th

Like a lot of other people, I chose the sleeve because I felt it's less invasive, I didn't want the malabsorption issues, and also, my surgeon recommended it because he said it would actually be an easier procedure for him to do because of how high my weight was. He also said that if necessary or if I wanted to, I could revise the sleeve to gastric bypass at a later time. I lost 70 lbs before surgery, and over 130lbs since (it will be one year on October 9th) and I am thinking I won't need the revision! I would like to lose another 25-35 lbs and I have no doubt I will.

I do agree with Lori, this is a decision you should make with your doctor. Like mine, he might have a preference and a good reason for it.

Mangopickle

personal history of vit d def and fe def anemia. RNY would have likely been a disaster for me. you can achieve normal wt for ht with either surgery.

boomerkae

Thank you all for the feedback!
When I first met with the surgeon, he said either option would be good. I had always leaned toward sleeve, but like I said, thought maybe I should go for gusto. I am a sweets fiend. However, I've done well these last few months. Chocolate protein shakes fix any of my cravings.

I am concerned about malabsorption and am not all that into having things rearranged. And while I don't want to have to go through this twice, good to know if for some reason I don't achieve goals with sleeve, there are other options. I have a friend who had bypass, has maintained for a number of yeara, but didn't lose as much as he would have liked. He shared that he wishes he sleeved first.

In conversation with the social worker at the baratric office, she feels the two options will show veey similar reaults, but of opinion that sleeve isn't as well documented long term. I am co-morbidity free, so I am feeling sleeve might be the better option.