I need help (pro/con) list.
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nakeddog
Posts: 79 Member
I was signed off after meeting the surgeon in early Dec, he went through the surgery options and basically left it up to me, I was approved for both the sleeve and the bypass.
I always thought I wanted the sleeve, and then he brought up some points about the bypass I hadn't considered before, by the end it was up to me, and I picked bypass, now I am unsure again.
I do not have reflux...which would make the tipping point be definitely bypass.
Con list for sleeve: lg stitch line, he said higher risk of leaking, also higher risk of stretching, tends to be less weight loss.
Con list for bypass: rerouting and involving intestines (this still scares me)
Pro: weightloss...but higher weightloss in bypass.
Same: vitamins for life
Another poster made a good comment too about taking advil...I have the occasional migraine, or bad cramps with heavy cycles...I take both tylenol and advil., now I can't predict if these things will ease up, and I may choose a hysterectomy at some point...but I can't function without pain aids. I never factored that in to one or the other, thinking they were not allowed for either...but does one tolerate it better?
Any help of this would be greatly appreciated, did you learn things that would have made a difference in your choice...happy with your choice?
I signed the form for bypass, but the surgery itself will be a year away still...Dec 2017 is my expectation.
I always thought I wanted the sleeve, and then he brought up some points about the bypass I hadn't considered before, by the end it was up to me, and I picked bypass, now I am unsure again.
I do not have reflux...which would make the tipping point be definitely bypass.
Con list for sleeve: lg stitch line, he said higher risk of leaking, also higher risk of stretching, tends to be less weight loss.
Con list for bypass: rerouting and involving intestines (this still scares me)
Pro: weightloss...but higher weightloss in bypass.
Same: vitamins for life
Another poster made a good comment too about taking advil...I have the occasional migraine, or bad cramps with heavy cycles...I take both tylenol and advil., now I can't predict if these things will ease up, and I may choose a hysterectomy at some point...but I can't function without pain aids. I never factored that in to one or the other, thinking they were not allowed for either...but does one tolerate it better?
Any help of this would be greatly appreciated, did you learn things that would have made a difference in your choice...happy with your choice?
I signed the form for bypass, but the surgery itself will be a year away still...Dec 2017 is my expectation.
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Hi @nakeddog I really think the decision is different for everyone. I had the sleeve surgery and am loving it. I think it is good that you have some time to make your decision.0
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When I asked the dr about malabsorption...thinking a sleeve is the better choice., but he was saying studies indicate they are the same, and both require vitamins for life.
So that made them the same. Reaction to sweets, greasy foods...dumping, I consider a pro, because I want to be reminded of not picking those foods., but I understand not everyone has this happen.
I am also afraid of failing...5 yrs, 10 yrs, 20 yrs...will any of this hard work be undone because I relaxed and it stretched out..the longevity was important to me. I want it to last...but I don't want to live a rigid life, I have a family and kids...I eventually want to enjoy some things with them, but don't exactly want to risk dumping every time someone has a birthday. I maintain weight very well.
Am I the only one with these thoughts...lol. I've read lots of info, webpages etc, and I know its a personal choice, the dr could not push me to one or the other, I qualified for both., and both would work well.
Honestly I think I want to go back and say sleeve...I see the clinic again in a couple weeks.0 -
I found this helpful, if anyone else comes looking for help too
http://www.obesitycoverage.com/gastric-bypass-vs-gastric-sleeve-surgery/
new thoughts to consider: bypass...all weight loss in 1 yr, sleeve...weight loss in two years. Slower weight loss is less saggy skin. Bypass, get to be at weight sooner. Sleeve, slower loss looks "normal" so you would avoid awkward conversation on how it happened, if you don't want to tell people about surgery.
More weightloss having bypass than in sleeve...my dr said the same thing.
My dr performs more bypasses than he does sleeves.0 -
For me I am happy I had the bypass. I can eat sweets and greasy without dumping but I lost the taste for it. For me the big pro was the immediate change to my comorbid issues. I went in to surgery a type 2 diabetic with high blood pressure and on 6 different meds, up to 8 shots a day. I woke up from surgery and tested within normal ranges on my sugars and bp. I have not had to take a pill or shot since. My sugars and bp have been well within normal ranges ever since.
Oh, and Tylenol is okay to take after the bypass. My surgeon prescribes tylenol with codiene for post surgery pain management.1 -
I also had bypass - I wanted the sleeve but my surgeon talked me out of it. He said the risks basically weigh out the same with either but bigger losses with bypass. I had an aversion to meats of all kinds for several weeks after surgery and dumped quite a bit for a few weeks but now I don't dump. I can tell if I eat something with too many carbs or sugars, and 8 1/2 mos out I still play around with stuff. One thing I continue to do is go to my weekly weight watchers meetings to help keep me accountable on the scale. Only a couple of my WW friends know that I had surgery but there are quite a few tidbits you pick up in meetings from other members..it also prevents me from falling into the mindset that my pouch will stop me from overeating or eating bad stuff. I had said in one of my previous posts that I still cool and bake with real sugar - I used to get chronic migraines so I try and steer away from
Artificial sweeteners as much as I can. I started the process with my surgeon and nutritionist telling them of pizza and ice cream were never to be had again post op then I will just work with a nutritionist and not have surgery.:both said I can have it but I will eat much less. They were right. In fact, I don't feel well if I have something with too much sugar or carbs even if they are sugar free or no sugar added items. It's all about learning your new stomach/body and what you can tolerate.
I think you will be glad with either decision, just figure out which goals you have - longer or shorter term results. My sleeves friends don't find themselves as hungry or eating hungry where o told my surgeon in the hospital I was starving (he was shocked). I think it is because the ghrelin isn't released after sleeve but still is after bypass - it's worth looking into1 -
Ok, the NSAIDs thing is a no-go for both populations. http://positively-healthy.com/nsaids-and-bariatric-surgery-whats-the-deal/
VSG and leaks...I've found research that shows about 3% of patients end up with leaks, of that 98% are controlled non-surgically.
The amount of weight lost surgery to surgery is still being researched because the sleeve on its own is still a fairly new procedure. According to my surgeon, I should have lost about 85lbs in my first year. I lost 165lbs. Him and my nutritionist are both shocked at how well I've done.
There is definitely more malabsorption issues with RNY. It's considered a malabsorptive surgery. VSG is considered restrictive. VSG needs vitamins because most patients are not eating a wide variety of foods and strictly focusing on protein.
My surgeon told me there is less risk of stretching with VSG because the stretchiest part of the stomach is actually removed, leaving more of the muscular part. It can and will stretch some, but not as much as people fear. Most regain is due to poor food choices, not the stomach stretching.
With RNY, the stomach is only altered as to make the new pouch. The new pouch is the stretchy part of the stomach. I have had two local friends who came to my surgeon as new patients and had to have their pouches resized.
For me, I was terrified of the malabsorption and the rerouting of things. More cutting and reattaching meant more chances for scar tissue and other complications (specifically stenosis and strictures scared me).
I have a history of reflux, and presented my case to my surgeon. He was quite impressed and made me understand that I will need antacids for life. I'm good with that. At this point, I take them every other day.
Ultimately, the decision is yours. I'd suggest researching your concerns and reading articles and research...not boards from other patients. *smile*
Good luck!3 -
I was personally iffy about having a bypass as rerouting my insides sounded a whole lot more invasive than simply removing part of my stomach. Also as has already been said, the bypass is a malabsorption procedure.
Having watched my wife for nearly four full years prior to my own surgery with her sleeve, she lost far more than the average 60% and aside from the usual loose skin, she is in her healthy weight range. She did almost all of her weight loss in the first year. 69lbs. for me would be the average 60% weight loss for sleeve patients, and I have already lost 67lbs. in just over four months with no signs of slowing down yet.
I haven't had any major food aversions. I can eat sugary junk if I want (in moderation of course), I just usually choose not to. My wife on the other hand lived on chocolate for a month it seemed. I cannot drink anything carbonated without stomach cramps from even a sip. My wife drinks diet soda all day long and a Coke when her blood sugar drops (she's type-1 diabetic). I'm eating every kind of meat except steak (yet), can eat small amounts of bread and pasta. A good friend of mine at work had the bypass and she can't handle most meats, sweets, pasta or rice. So everyone is different. I'm happy with my sleeve and think it was the right decision for me, but your personal choice is entirely up to you.
As Nicole874 was saying, I too have acid reflux which has nearly completely gone away since my surgery but has reared it's head 3-4 times since. I consider a couple of fruit-flavored Tums my bedtime snack.
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I had the sleeve in March 2016 after doing some (a lot) of research. I feel like it was the best choice for me. I don't have too many issues handling food, with the exception of carbonated drinks (gives me wicked heartburn) or if I overdo it with treats. One of the major reasons I chose the sleeve is I still want to have kids and I felt like a malabsorption procedure was a bad idea for that.1
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It's different for everyone, but I'm very happy with my sleeve. In my case I already have malabsorption issues from gluten intolerance and have chronically low iron, so making those problems worse made no sense for me. The idea of rerouting intestines also just freaks me out.
Early on in the surgeon's office I met with the insurance lady and she confirmed I was interested in VSG. I said "probably" and she leaned over and whispered "Sleeves have a lot fewer complications post-surgery". Decision made! (I realize she was the insurance rep and not the surgeon, but as the one who runs all the insurance, she probably knows who has what problems!)
It's different for everyone. Do your research and make the right choice for you.1 -
chubby_checkers wrote: »One of the major reasons I chose the sleeve is I still want to have kids and I felt like a malabsorption procedure was a bad idea for that.
My sister-in-law had bypass and had a healthy pregnancy and a big healthy baby boy last year.
I chose the sleeve, I have had no complications and lost a lot of weight. I have personally seen people who had bypass stretch out there pouch and have lots, if not most of their loss, regained. No matter what procedure you choose, you will have to be disciplined for life.
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A woman on my friend list had did the same and had a healthy pregnancy. I have other issues and didn't want to add an additional risk. :-)chubby_checkers wrote: »One of the major reasons I chose the sleeve is I still want to have kids and I felt like a malabsorption procedure was a bad idea for that.
My sister-in-law had bypass and had a healthy pregnancy and a big healthy baby boy last year.
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I had the bypass in April 2016. I am terrified of regain but will say that I eat pretty much everything but a lot less of it. I also keep going to my weekly WW meeting so I can keep myself accountable and prevent the regain. I did want sleeve but my surgeon highly recommended the bypass. Someone told me it was probably because it would give him more $$&. Either way I am glad I had WLS regardless 2
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RNYGB in 2014 - down 130 pounds and holding. No problems with nutrients, yes I take vitamins everyday, but I'm not taking blood pressure, GERD, or cholesterol drugs everyday - I'll take that trade. I don't feel limited in eating anything I want to eat, but have learned to want mostly produce and protein. At two years I'm almost not even thinking of myself as a bariatric patient anymore. I'd do it a thousand times over.2
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Thank you so much everyone, I appreciate all this feedback. I can and do read all the other postings, and many websites, but having a group of people I've come to know, makes me feel better knowing your experiences.
You have brought up some great points, and sounds like sleeve is doing better than my dr lead us to believe, I may not need the more drastic measures if the sleeve is capable of getting the same 1st year results, and without stretching. I haven't come across that info before, about stretching, so thanks for that info, I am so optimistic now about going back to sleeve.
I am continuing with meeting the staff at the clinic, I now have all the scheduled appts laid out ahead of me...and I am on my way. Hubby got me a treadmill, so I can walk indoors. I've given up drinking carbonated beverages...now it might be 1 a month., just because I do enjoy the taste., but I am ready to say goodbye to it.
My eating choices have completely turned around, much more nutrient dense, and focusing on protein has become 2nd nature. I am still struggling with losing weight, I seem to have a set point, and it maintains well...but I do believe I will make their 10% goal, but man perimenopause sucks. I have had chronic low iron since I turned 35...I will be 45 when I get the surgery, but it all due to the monthly cycle.
Back in my hometown, there is one lady I was speaking with today...through e-mail. I knew she had surgery but forgot which one, I thought it was bypass because she has lost a tremendous amount in her first year. She had the sleeve, and surpassed what they thought she'd do in one year. Her one issue, is before surgery she had reflux and it never went away. But everything else, she said went well, she tolerates her vitamins and she never said anything about food, but if she needs to, she has taken pain meds., and it was tolerated. She had her skin surgery, and then had her arms done. She has kept the weight off, but after the skin surgery, she had gained 10lbs...but is still maintaining, it is something she continues to work at. Aside from her, I have only one other person, and approx 18 yrs ago, she had the bypass...but she never lost much weight...she is certainly better, but her sister said she gave up and undid all the work by poor choices. So I know the surgery only takes a person so far. But these two ladies are the only ones I knew of personally to have gone thru it.
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Glad we could be of some help.1
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Honestly, for me, I am just not even comfortable with the bypass. My surgeon wants me to get it but it just doesn't feel right and i cant get a surgery I am not comfortable with. That's really the big reason for me getting the sleeve.1
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There really is very little difference in resultsand experiences between VSG and RNY. The differences in how fast, how much, and if you keep off the weight are pretty negligible. NSAIDs are a no go for both. Excess skin will be identical, regardless of how fast or slow you lose.
The biggest issue is GERD. I have seen too many sleevers come down with reflux after surgery, either right away or even after a few years. Three people I know IRL had to convert to RNY just to get rid of reflux. But really, everything else is a tossup.2 -
nakeddog - It isn't an easy decision to make, sleeve versus full bypass. Since you have a year to decide you have plenty of time to research. I made my decision based on the amount of weight I needed to lose, my weight loss success in the past, and the doctor's recommendation based on my medical history at that time. I exceeded my weight loss goal in about 16 months. I actually lost 20 additional pounds while I was trying to figure out maintenance. I've maintained that loss for 7 months. It still takes effort in maintenance with eating right and exercise. I think there is a myth that there is a honeymoon period of weight loss with the sleeve and you can only lose 70 percent of the weight you need to lose. I think it's all up to the individual and you can chose to be part of the 70 percent statistic or you can elect to be on the other side and push past the 70 percent to the 100 percent loss group. You have a year, talk with your primary care physician, interview people who have had both the sleeve and full bypass to make a workable decision for your life. Good luck with your journey.3
