My mind is a jumble and it seems I cannot make a decision...looking for some help please

 Hi, my name is Diana and I had my Lap-Band removed in July 2011 due to continued nausea, vomiting and inability to eat.

I am scheduled for surgery and until yesterday was pretty solid that the right decision was to go with the RNY. However, my surgeon wants me to consider the VSG. My BMI is a little over 40 - (40.4 maybe) and I do know that one of my issues has been what I've heard people refer to as "head hunger"...sometimes not really hungry but craving a particular taste. I do not know if I would classify myself as strictly a volume eater...and I can say that I've had a difficult time losing weight over the years which leads me to believe that my metabolism is not great. I tend to lose a little and easily put it (and then some) back on.

I do realize that WLS is a personal choice and we all have to do what we feel is right for us. I am have been told of the complications of dumping, nutritional deficiencies and the like which can occur with either the VSG or the RNY (tho certainly more prominent with the RNY). I am not sure that strictly restriction is going to be enough but I don't want to do more than is necessary either. What keeps bringing me back to the RNY is the long-standing research that VSG doesn't yet have. RNY is still consider the "gold standard"... but.... if I didn't have to be re-routed in the intestine department and could still get down to a normal weight - I would SO DO THAT.

My mind is reeling and I feel torn between the VSG and the RNY... can anyone offer insight?

Thank you in advance!

when you have dieted in the past have you lost weight? if you have then I would think the VSG would be a real alternative for you as it will restrict the amounts you can eat.

you can still eat crap from cravings with any surgery.

are you diabetic? if you are diabetic I'd lean towards RNY or DS

The fear of reactive hypoglycemia and the fact that it is linked so strongly to the RNY would make me seriously consider VSG or DS if I were deciding today. I've been lucky, haven't had problems but these are some of the things I'd consider if I were you.

Good Luck!! Judi

Have a read of my post about two or three below this one on the main board.  You should go with the DS or the VSG if you have a BMI over 40.  Just my thoughts on the matter.....plus there is lots of empirical data on the success of the DS long term.  For me the overwhelming point was where I would be in 4 years time. I chose the surgery with the least regain potential as I am determined to only ever have one surgery....and it has to be the RIGHT surgery!!!

OT:  Hey, Squashblossom!

Where the heck are your cool posts?  I love reading your rants and free-form excursions
into lit-ra-chure. 

Hugs,

MWAH!

If I had it to do over again I would do the DS.

You still can, can't you?  You have to have the intestinal portion of the surgery completed as youy have the 1st half, the sleeve, already.

Surgeons look at current health tests, evaluate your health issues, consider medications currently used, etc. in helping you decide on a surgery.  No need for daily NSAIDS, non diabetic, and no GERD will make you a good candidate for the sleeve.  From my support groups, my surgeon's bariatric nurse says that the sleeve surgery generally averages 100 pounds wt loss, with generally slower wt loss rate than RNY.  And yes, the RNY has a long data history compared to the VSG.  There are 2 sisters in one of my support groups. The sleeved sister had surgery 1 year prior to her sister's RNY surgery. The RNY sister has lost more wt  in a year less time.  This sister also publicly states that he sister has "learned to cheat her sleeve surgery" which keeps her wt loss at only 80 pounds.  She also states her sister could stand to lose another 100 pounds.  At a recent support group, a new member asked my surgeon's bariatric nurse which surgery she would have (she really is in good shape and doesn't need the surgery).  She said that if she needed wt loss surgery, she would chose the RNY. She stated the thought of removal of part of the stomach worried her somewhat. She posed the issue that if she came down with stomach cancer, the sleeve surgery would complicate this problem. DAVE

You make it seem like the differences in the sisters is because of what surgery they had. But you can eat around any surgery. There are plenty of people who eat around the RnY on these boards. So their differences are due to their approach to surgery, not what type they had. 

If you look at the clinical data, VSG and RnY are getting similar results in the long term. If I went to a surgeon who told me his sleeve patients didn't lose as much as his RnYers, I'd go find another one who was doing the sleeve properly in order to get maximium results from it. My surgeon finds that his RnY and VSG patients lose about the same. That's part of why I picked him.

My observation is that these surgeries (except the band) give people around a 70 to 150 pound weight loss without having to do much. If you want to lose more, you have to work them. That seems to be true no matter what the surgery type. DSers have the best lost on paper but there are DSers who don't get to goal and *****gain, so it's not a magic bullet.

With RnY, you have malabsorption at first. But eventuallly your body figures out how to absorb those calories again. So now you have malabsorption of micronutrients for life but no malabsorptoin of calories. It's all risk with no benefits IMO. I think that, if you are going to go for malabsorption because you think you need it, then it makes sense to get the DS and have malabsorption for life.

I'm not biased towards one surgery vs another.  Each has pros and cons. COMPLIANCE by the patient is the reason for the wt loss success AND more health issues can arise out of not taking the required supplements.  Dave