6 Month Pre-Op Check In And Green Light For Surgery
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relentless2121
Posts: 431 Member
Hi Everyone, my 6 month pre-op check in went well yesterday and the psychologist, kiniseologist, nurse and dietician all gave me the green light to be referred to a surgeon which is the next step here in Canada.
My weight was 294.6 from 317.4 in February. I'm down close to 24 lbs. I was told that the objective was weight maintenance and not to gain wait at my 1st appt. I'm sure this depends on each individual but I figured every lb. down helped prepare us for surgery.
Although they were all happy with my progress, food plan and exercise plan except for the stall I had I did leave the appt. feeling somewhat confused for a few reasons.
1. The Dietician was very concerned that I wasn't getting enough carbs and fibre. I'd be the 1st to admit my fibre has been low since I cut down on bread and no longer have potatoes or pasta in my diet. Most of my carbs are from 1 slice or two of whole grain bread each day and from fruits and vegetables. She wants me to increase my calories (even though I'm feeling very good about my diet and on cutting down on carbs). I don't mean to go against her and will follow as instructed but I could barely lose before reducing carbs.
2. Here is the biggest recommendation I received yesterday. Other than the psychologist they all recommended that I have RNY instead of VSG based on my BMI of 49. I really am very confused about all of this. Of course until I meet with the surgeon in hopefully September and get the surgeon's input it's hard to make this decision. I thought my decision was made and now I am finding out that I might be pressured to change it. They told me that people of my BMI tend to do better on RNY. As you all know from my posts and involvement on this site, I really do not want to pursue the RNY option but feel I must do more research, be openminded and serious take the advice of my surgeon. By the way, my surgery will be in October or November as September is fully booked already. That is fine with me as I could use the extra time to get some things organized and prepared as well as stock up on the listed post-op diet as I don't want to be out that first week or two shopping if I can help it.
3. I know that many of you have had to fight hard to have VSG instead of RNY, especially if you had your surgery a few years back. I really don't have connections with the RNY community or know anyone personally that has had it. All I know is that I am a very sensitive person on the inside and out and prone to infections and complications with almost anything medical. For that reason and not wanted my bowels messed with I was really leaning towards VSG. Of course I want to set myself up for my best chances of success. I realize that whichever one I have that the surgery is only a tool and I will have to put the work in with daily food choices and a regular exercise routine.
I know that I have been immersed and involved with the VSG community hear and really value your feedback. I'd appreciate any perspective you can give me. If you had to fight for VSG, I would value any pointers you have to help me state my case to the surgeon. If you know of people who had RNY I'd be interested to hear how they have made out and if they have regretted it.
Ultimately I will value the surgeon's input greatly.
Thanks all for your support and I continue to value all of your feedback. :flowerforyou:
My weight was 294.6 from 317.4 in February. I'm down close to 24 lbs. I was told that the objective was weight maintenance and not to gain wait at my 1st appt. I'm sure this depends on each individual but I figured every lb. down helped prepare us for surgery.
Although they were all happy with my progress, food plan and exercise plan except for the stall I had I did leave the appt. feeling somewhat confused for a few reasons.
1. The Dietician was very concerned that I wasn't getting enough carbs and fibre. I'd be the 1st to admit my fibre has been low since I cut down on bread and no longer have potatoes or pasta in my diet. Most of my carbs are from 1 slice or two of whole grain bread each day and from fruits and vegetables. She wants me to increase my calories (even though I'm feeling very good about my diet and on cutting down on carbs). I don't mean to go against her and will follow as instructed but I could barely lose before reducing carbs.
2. Here is the biggest recommendation I received yesterday. Other than the psychologist they all recommended that I have RNY instead of VSG based on my BMI of 49. I really am very confused about all of this. Of course until I meet with the surgeon in hopefully September and get the surgeon's input it's hard to make this decision. I thought my decision was made and now I am finding out that I might be pressured to change it. They told me that people of my BMI tend to do better on RNY. As you all know from my posts and involvement on this site, I really do not want to pursue the RNY option but feel I must do more research, be openminded and serious take the advice of my surgeon. By the way, my surgery will be in October or November as September is fully booked already. That is fine with me as I could use the extra time to get some things organized and prepared as well as stock up on the listed post-op diet as I don't want to be out that first week or two shopping if I can help it.
3. I know that many of you have had to fight hard to have VSG instead of RNY, especially if you had your surgery a few years back. I really don't have connections with the RNY community or know anyone personally that has had it. All I know is that I am a very sensitive person on the inside and out and prone to infections and complications with almost anything medical. For that reason and not wanted my bowels messed with I was really leaning towards VSG. Of course I want to set myself up for my best chances of success. I realize that whichever one I have that the surgery is only a tool and I will have to put the work in with daily food choices and a regular exercise routine.
I know that I have been immersed and involved with the VSG community hear and really value your feedback. I'd appreciate any perspective you can give me. If you had to fight for VSG, I would value any pointers you have to help me state my case to the surgeon. If you know of people who had RNY I'd be interested to hear how they have made out and if they have regretted it.
Ultimately I will value the surgeon's input greatly.
Thanks all for your support and I continue to value all of your feedback. :flowerforyou:
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Replies
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I was 295 the day of my surgery with a BMI of 47.6. Here in Newfoundland they rarely do the RNY and from my understanding most people do as well with the sleeve as they do with the RNY. I am 24 weeks and 2 days out from surgery and down 83 lbs my BMI is at 34.5 now. I no longer have diabetes and my blood pressure meds have been cut in half. I know another lady that I am very good friends with that had a BMI of 60 on the day of her surgery and she has done extremely well losing 200 lbs in just 1 year. I am not sure why they would recommend the RNY but I guess if I were in your situation I would listen to what the surgeon thought was best.
You have done an amazing job getting ready for your new journey. I admire your ability to do that. The only thing I was able to do was give up soda and watch portion sizes but I didn't lose any weight. Hopefully when you get to see the surgeon you will feel better about things and he can explain why the RNY would be better than the Sleeve.
Newfoundland is the only province in Canada that doesn't have a psychologist involved with the bariatric program I feel strongly that we should have one as most of us have food addictions that we don't even realize until after our surgery is over.
I know these values change after surgery but I am not sure how much. I have 77 grams of carbs for today and I think that is on the high side. I have my 6 month post op appt on the 29th I will ask my dietitian where my carbs should be. As they only really focus on protein and calories here.
Good Luck! Can't wait to hear what your surgeon says.0 -
Congrats on getting the clear for surgery! I started at 315 so RNY was suggested to me also. But my doctor said that the sleeve will work just as well, as long as I am willing to work the tool. It was hard for me to decide on weight loss surgery and I just couldn't do anything other than the sleeve, because I didn't want my insides re-routed. Spend some time doing some research and talking with people on here so that you are educated when you meet with your surgeon.0
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The sleeve can be converted into a RNY further down the road but not the other way around. All the research I have seen is that the sleeve works just as well as the RNY for those who follow the program. Best of luck in whatever you decide!0
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Thank you all for the posts. I'm not taking yesterdays recommendations for RNY from the clinicians although it as got me wanting to research it more and get feedback from those that have had it.
Ultimately I will take the surgeon's recommendation more serious. I know that they only want what is best for us and I also get the impression that the sleeve does require more self-discipline, but then again that could be a misconception on my part.
I am still leaning towards the sleeve if it is available to me. I have mesh within me from a Laproscopic Hernia Repair that was actually performed by the Head surgeon of the Bariatric Department long before it existed here. I am hoping to get that surgeon again as I had a lot of success with him. The mesh from my appendix complication could possible limit me to only one form of the surgery. I'll find out more when I have a consult with the surgeon.
I'm trying not to freak out about the idea of possibly having RNY. I have some time to research and investigate and talk to others that have had RNY. It 's just that I've had my decision made up for so long I can't imagine changing it now. Who knows... maybe RNY would be a better match for me. I need to be openminded and not panic about the whole thing.
Thanks again for all of your support. :flowerforyou:
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I had the sleeve and my starting weight was 382, I think my BMI was like 60, no kidding. My surgeon recommended the sleeve because he said that sometimes it's more difficult to do bypass/RNY on someone my size. I was fine with that because I had my mind set on the sleeve.0
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I initially wanted the RNY due to the best chance of losing 90% of my excess wt. but my Dr recommended the sleeve due to my long history of anemia and vit d deficiency. I have been on iron and vit d for yrs just to barely stay normal. The surgeon also wanted to do RNY due to the better outcomes in terms of wt loss. I spoke to 4 pts who had RNY who had had prior anemia and were suffering severe anemia requiring infusions monthly. I also noted that 5 yrs after surgery it wasn't the surgery type that made the difference but the persons willingness to change to the new lifestyle and stop medicating with food. We have both types of pt's in our support group. Also my BMI was 39-40 so I was in a range common for the sleeve. I think my surgeon was afraid that since I had been obese for all of my adult life that I would resist strongly to changing my life and he wanted to give me a stronger tool to fight with. He warned me that he thought the most I was likely to lose was 50-70% of my excess wt. Now I am 1 lb overwt for my height. I hope to lose this final lb and be normal wt for ht by the end of the month. my goal is to never weigh over 155 the rest of my life. The surgery got me the first 30 lbs after that It has all been my own work and daily choices. You can absolutely lose to a normal BMI with both surgeries. It is a bit easier to eat around the sleeve but both surgeries can be defeated with choosing not to follow the lifestyle.0
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If the prescription is for more fiber, try Quest bars. 23G of protein and lots of fiber to boot! As for sleeve vs R\Y, I was undecided at my pre-op consult and with the help of my surgeon, came to the decision that the sleeve was right for me. I have another friend with the same surgeon who was directed towards R\Y because of his high BMI. He's had his procedure and is doing great now. Down well over 100 pounds. There are plusses and munuses to both procedures. I have no doubt that you'll do great with whichever procedure you end up choosing.0
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Congratulations on the green light! I think Mango said it best- in the end- it's not the surg- it's the person who has it and how they use it- still, I understand the hesitation on anything that reroutes your guts. There's still time to decide- and in my experience, I would just hope that the surg you see does both- because they like to do what they know. When I had my first consultation- I wanted the band, and the surg talked me out of it- I’m glad I listened but I had similar feelings at first.0
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Relentless, I went into this at 386 with a BMI higher than yours. I told my doctor from the start I wanted the sleeve and if I could not do that, I wouldn't do anything. So continue to educate yourself. Before I decided to be sleeved I spent years researching all the surgeries, looking at what each of them do (how they work, disconnecting , rerouting, malabsorption issues, never taking certain drugs or having certain tests again, etc.) and analyzing weight loss results AND I have 4 family members who had RNY with only one of them really being successful. All those things left me knowing I PERSONALLY didn't want that surgery. So, don't completely rule it out, but don't let them talk you into something you don't want either. Continue to research, listen to your doctor and then make the decision based on what you believe is best for you.
One more thing. I am not saying RNY isn't a good surgery. There are a lot of people who have it and are very successful with it. I'm only stating the reasons why I chose the sleeve and encouraging you to make the decision with your doctor and your own reasearch.0 -
I had been thinking about weight loss surgery for a number of years but could never bring myself to do it because I was not comfortable with RYN or the lap band (which were the only two I thought there was). I gave up until I heard about the sleeve. I did more research and was completely comfortable with the surgery.
When I had my pre op appointment with the surgeon, he suggested the Duodenal switch for me. I wasn't comfortable since it was part RYN so I told him I was sticking to my original decision. Like someone else mentioned, he said he could work for me as long as I put in the effort and didn't slack off.
I'm not sure how it works in Canada but I hope you are able to do the surgery you are most comfortable with :flowerforyou:0 -
Thank you everyone for your comments and also for your faith in me and for the kudos you all gave me. :flowerforyou:
Although I haven't met with a surgeon yet, the RNY recommendation came to me from the Dietician, Nurse and Kinisiologist (movement specialist). They had implied that it was more suitable for my weight history and my current BMI of 49.
One of them told me that they see a lot of people coming back really struggling with the sleeve.
I think they just have my best interests at heart and want to set me up for success.
That being said, the little I know about RNY does concern more for a few reasons. Correct me if I am wrong here but:
1. It is a more invasive surgery.
2. They reroute part of your bowels. I REALLY DON'T WANT MY BOWELS TO BE MESSED WITH.
3. The malabsorption issues are worse.
4. You are more prone to dumping syndrome.
If those things are all true, that really scares me.
With how sensitive a person I am and prone to infection and skin sensitivities etc. and I'm allergic to 4 types of antibiotics. Have psoriasis, excema and asthma, but not sleep apnea. I just think that my very sensitive systems could easily be affected by complications.
I don't want to not be able to leave my house because I always have to be within running distance to a toilet.
Now please correct me if I am wrong with my perception of the disadvantages of RNY that I have come to believe (but know that I can be misinformed and have the wrong perception of here.)
The lap band isn't covered through my health care and from what I know about it, many people end up having infections or complications to it.
The Team of surgeons all perform all 3 of the WLS as far as I know as there is a private clinic in my city where people can go and pay to have all of the procedures done.
I am praying that I get the head Bariatric Surgeon on the team who operated on me before for a laproscopic incisional hernia repair that was a complication that developed months after my appendix surgery. I know and trust him and if he recommends RNY for me, I guess that is what I will do. Of course I want to set myself up for the best chance of success too.
There are no coincidences, I met someone a few hours after my check in through a mutual Christian Facebook friend and it turns out they had RNY 5 years ago and are doing very well with with it. After Facebook messaging about it and asking some questions they recommended a Skype chat. We plan to do that in a few days as I am not set up on Skype yet. (yup... I am a dinosaur. lol). Perhaps that person will help me clear up some misconceptions.
Thanks again to everyone for all of your support. I will keep you posted on my journey. 0 -
The Team of surgeons all perform all 3 of the WLS as far as I know as there is a private clinic in my city where people can go and pay to have all of the procedures done.
I am praying that I get up for the best chance of success too.
My surgeon won't even perform the lap band and will only do the sleeve, RYN, or the DS. He said it was due to bad complications, infections and that it just doesn't work as well as the other 3 options.0 -
My BMI was over 51. I guess they are using the stats for their opinions. I was told if I was 10kg more they would have recommended RNY instead. But my GP was very surprised last week that I had exceeded 40kg loss. I guess he reads stats too. However, there are folk on here who had a much higher BMI than even me and they committed to the program and have been so successful. I guess in my opinion, you do what you feel is best for you not just for their stats.0
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I had my sleeve done in the uk. I had a history of bowel issues so had to have the sleeve. That was the op I was hoping for so it was good for me. If you have any medical history of stomach or bowel issues they may not do the RNY. My BMI was 59 pre op and it is now 31. All forms of weight loss surgery can be beaten and so attitude and mental health plays a huge part.0
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Don't get me wrong, I love my sleeve and believe it was the right choice for me, but I think the gastric bypass is a great surgery and I really think you should not dismiss it based on vague things like "I don't want my bowels messed with." All of these surgeries are drastic. Anyone can psych themselves out of a particular surgery by thinking something like "I don't want a foreign body implanted in my stomach!" or "I don't want most of my stomach cut out and thrown away, too drastic! Irreversible!"
My surgeon's support group is mixed bypass and sleeve patients, and the bypass patients seem to be doing great. They look fine, they have energy, their teeth are not falling out, their hair is not falling out any more than the sleeve patients' -- i.e., no one can tell their hair is falling out anyway. They are losing weight rapidly, they are happy and look healthy. I haven't noticed that they need to be close to a bathroom
My niece had gastric bypass and has lost over 150 lbs and maintained it for over four years now. She looks great and is perfectly healthy.
Yes, you do have to take vitamins with bypass -- but you also have to take them with the sleeve. That's a wash IMO.
It sounds like you are on the right track in terms of talking with people who have had these surgeries and exploring all your options and recommendations with medical folks. Good luck in your decision!0 -
That's a good point, SybilDiane. I have two family members who have had RnY and their daily life is not obviously hampered by the surgery. I was expecting to have RnY when I started the process.
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Thanks for your feedback everyone. My current BMI is 49 down from close to 52. I think I forgot to mention that. 5.5 (thought I was 5.6) and 294 lbs. 0
