Hearing So Many Different Things. :/ VSG vs RNY. If you could do over would you change which you had?

[GypsyMom 0]

So... I have been going back and forth about this until I get details back from the surgeon about what exactly my insurance will cover. I have researched VSG and RNY online as well as talking with people who have had weight loss surgery. I am scheduled to attend a seminar this month and I am sure I will get all my questions answered there by the surgeon. However... in the meantime I keep hearing so many different opinions about the two surgeries that it is making me question my choice a tiny bit. I had someone ask me why I wanted the VSG over the RNY. (They had RNY done). I explained how I felt worried about some of the complications associated with RNY and also the malabsorption issues. Also Not sure how I feel about not being able to take certain meds and being on Vitamins the rest of my life. Also... I would like to think I could enjoy a cookie once in a blue moon without issues or dumping. I have also heard that people get the max results from RNY vs VSG. On the other hand... I have been told things about RNY patients having a higher chance of gaining the weight back after 3 years or more and I noticed on the RNY board... several postings about people feeling very hungry all the even though they had surgery. This is something that also worries me. I don't want to be hungry all the time or feel like I am starving, I am pretty set on the VSG procedure.. that is IF my insurance will cover it, which I hope they do. But some people keep telling me RNY is best. I am starting to get alittle confused now. Did anyone question themselves and if you could change which surgery you had done would you and why? Thanks so much!

[Tiffykins 673]

I can give you my reasons for VSG over RNY. . . Personally, it's something that you have to decide for yourself and what you are willing to live with for the rest of your life. This is an extremely long post, but please read until the end as the reasons really come to light with my recent pregnancy. If you would like any medical reports, articles, studies to back up these reasons, feel free to let me know, I just don't want to bombard you with too much. But, I have it all for reference.

This is my standard reply when this question pops up every couple of days. I won't try to sway anyone one way or another, but I'll give you my reasons for choosing VSG over RNY for my revision from the band. You can also check out the revision, failure, and food issue forums on here to get an idea of some long term RNY patients. For me, it was never an option. The cons outweighed the pros.

The VSG was my 2nd, and final WLS. I could have easily had RNY, but I fought to have VSG as my revision from the band. Some factors I considered in deciding on VSG. The pouch that RNY offers is similar to the pouch with the band. Least to say, a pouch sucks, I love having a normal tummy, just less capacity and still fully functioning.

1) No blind stomach left behind that can be difficult to scope yet can still get ulcers and cancer.

2) 2 years max on calorie/carb/sugar malabsorption, but a lifetime of vitamin/nutrient malabsorption. This process is called adaptation, and it happens with intestinal bypass surgeries.

3) I had a pouch with the band, and it sucked. I'm pretty fond of my pyloric valve and the sleeve let me keep it. I love having a normal functioning stomach, just smaller in capacity.

4) Regain stats and #of RNY patients seeking revision truly scared the poop out of me

5) I have too many friends in real life that struggle with Vitamin deficiencies post-RNY, and most of them either never got to goal, or have gained back a significant amount of their weight.

6) The long term complications with RNY were too numerous for my comfort level. Pouch or stoma dilation, strictures, vitamin/nutrient deficiencies, ulcers,

7) I researched gastrectomies that had been performed for stomach cancer and ulcer patients, and found comfort in the long term results and minimal complications of patients that had lost most or all of their stomachs had dealt with over several years.

8) I was a volume eater, and knew a restrictive only procedure would work for me. That was my thought process when I got the band, and I thought I could beat the odds on complications. Sadly, the band only lasted 8 months before I had to revise.

9) I did not want to have food or medication restrictions. I chose WLS to have a "normal" life, and I think it's normal to eat a couple of Cookies. With RNY, I wasn't willing to go through the possibility of dumping if I wanted to have a couple of Cookies, or a slice of cake on occasion. The big scare for me is medication restrictions for life. NSAIDS and steroids are a NO GO for life with a RNY pouch. I realize that I may never be diagnosed with a condition or disease that requires steroid use, but it is possible. I want the best long term results with the least amount of complications. Malabsorption is not anything to play with in my mind, and I was not willing to take that risk.

I lost all my weight in my ticker with the exception of 7lbs with the sleeve, and I did it in 10.5 months. The 115lbs fell off the first 6.5 months, and then the rest I lost as I was getting into maintenance over another 4 months.. It's been a fabulous journey, and I'm easily maintaining with zero issues for nearly a year at this point. I want to add that every WLS regardless of your choice will require discipline. Only a percentage of RNY patients dump on sugar/fat, pouches and stomas stretch, then you have the medication restrictions. I'm not trying to convince you, but these were my concerns when I knew I had to revise from the band. I started at 263 the day of my revision and today I weigh 127lbs. I bounce on the scale 125-130lbs any given week, and I couldn't be more ecstatic!

Best wishes in your research!

P.S. I wrote this before pregnancy. And, just as an update, I'm 8.5 months pregnant and thriving (Actually I'm 14 days from delivery, this was written several weeks ago, it's just me being lazy with the copy/paste). I have zero issues consuming enough calories/protein/carbs to support my body and another developing human. My labs have remained stellar throughout the pregnancy, and life is pretty good. I am over 2 years out at this point, and couldn't be happier with my decision to have VSG over RNY for my revision. It's been an amazing journey.

P.S.S.

Since the pregnancy, I have been diagnosed with a genetic clotting disorder and the ONLY treatment (zero cure) is a daily aspirin therapy. With VSG, this treatment is possible, if I would have gone with RNY my doctors (surgeon, 2 ob's, PCM) are unsure how this condition would have been treated especially during the pregnancy. Grant it, I only take a baby aspirin every day of my life, but it is an NSAID. Least to say, when my high risk ob found out I had a partial gastrectomy and NOT RNY, he was elated because there really is zero other option for treatment at this point, and the aspirin therapy is working well with my platelets and if all goes as planned, I will be able to have an epidural for my c-section instead of having general anesthesia. Maybe a small issue to some, but being awake for the birth of my daughter is top priority for me.

As a very recent addition; as of 10 days ago, I was advised I would have to be given a steroid(dexamethasone or prednisone) to help get my platelet count up as they have dropped. If I would have had the RNY, this would NOT be possible, and pretty much general anesthesia would be required for the csection. We're looking at other options for delivery such as a spinal block instead of a full epidural, but the doctors are positive the steroids will get my numbers up. At any rate, if I would have chosen RNY, I would surely not be able to have steroids. Looking back, I can't tell you how grateful I am that I was able to choose VSG.

[iegal 460]

Pretty hard to add anything after Tiffykins. Listen to her - she is not trying to "sell" you anything. I never considered RNY since I have two good friends who have had RNY surgery. Personally have watched side effects of RNY. I did not find this site until after I had chosen to have VSG on advice of my surgeon. Went in consult for a Band and he suggested VSG instead. Once choice was made I started reaching out to find others who had had this surgery and walla - VST website. Joined less than 2 weeks before surgery when on preop diet.

Now about my good friends - One has had revision surgery at 9 years out since her intestines which were rerouted wrapped around causing a blockage. While she does not experience dumping, and most do, the malabsorsion issues has caused damage to her long term health.

The other is under 1 year out. She makes me feel blessed to have chosen VSG. Came back from vacation with her and posted about experience. It is obvious she has had WLS since she almost daily experience issues common to this surgery. I experience no such issues.

I live like a normal person today, just not longer live for the next buffet. I eat crap every so often...maybe too often but that is another story. Agnin, repeating what Tiffykins said, only you can make this choice for you. How do you see yourself next year at this point? Rerouted or restricted?

Hugs to you!

[Tiffykins 673]

Ohhhhhhhhhhhhhh and here is my update from today on obesityhelp regarding my platelet counts and prednisone therapy:

PLATELET COUNT - 121,000

WOOT WOOT. . . The Prednisone worked beautifully, and all the crankiness, little weight gain, increased hunger ARE ALL WORTH THE END RESULT ! ! !

"Thank you" just isn't enough for me to say at this point for all y'alls support and prayers/good thoughts/swinging chickens ! ! !

We were hoping for a jump to at least 85,000 and here we are at almost normal level. Just for reference, I started off around 70,000.

Again, without VSG this would not have been possible, and I'm elated and beyond blessed once again that I chose the "right" surgery for me, for all the "right" reasons ! ! !

I'm cleared for the epidural, and will be awake for Tatum's arrival ! ! !

[GypsyMom 0]

Wow... thank you very much for your reply. At this point I know I want the VSG. I am just so scared that insurance won't cover VSG and I will have to get RNY as an alternative since I can not afford to pay out of pocket. That is my main concern now. So I guess I have to wait and see.

[Tiffykins 673]

Wow... thank you very much for your reply. At this point I know I want the VSG. I am just so scared that insurance won't cover VSG and I will have to get RNY as an alternative since I can not afford to pay out of pocket. That is my main concern now. So I guess I have to wait and see.

And you can appeal, there is no reason to just let insurance deny you. I can help with that as well.

Don't just have a surgery because insurance will cover 1000s of people win appeals for VSG for numerous reasons, so please just don't give up and get a surgery that you will regret in a few years.

[Felicia 28]

I originally wanted RNY. I walked into the Surgeons office confident that I would fight for RNY no matter what. I have wanted the RNY surgery for 10 years now and just never had the nerve to get up and go do it. I walked out of my Surgeons office that day signed up to get the sleeve lol. The sleeve was actually the one I wanted least, I picked Lap-Band as my second choice and sleeve as third. If I knew then what I know now it would be VSG, RNY, Band.

Here is why I am going to have the sleeve done VS. having the RNY done. Like tiffy said you have to make your own decision and I am not trying to convinve you this is the right way to go, it's just the right way for me to go. Also, I know Tiffy basically summed it all up for you but I will throw in my 2cents anyway just because I am a person who really really wanted RNY in the beginning.

The Surgeon convinced me to get the sleeve because you lose almost as much weight without the malabsorbtion. That's a huge deal, especially in the future.

In my case I also want to have more babies. I only have one 2yr old daughter and I am only 26 so having more kids is a huge YES in my book. The wait time between the VSG and the RNY are slightly different at his office. 18 months after surgery with VSG and 2 yrs after surgery with RNY. I will probably wait at least 2.5 years after surgery to even think about getting preggo again, I want to enjoy the skinny me awhile lol. I like knowing I could get pregnant earlier if I wanted to or had to. He also told me RNY adds more risks to a pregnancy as tiffykins said, so being I had a pretty rough pregnancy the first time around I won't do anything to add to it this time around. No problems on the babies end, all the problems on my end. I was a stinkin' wreck my whole pregnancy.

Besides the pregnancy thing, which might not be something you care anything about, the Surgeon said it is less down time. You actually start feeling better faster, and back to a normal way of life faster. I mentioned earlier I have a 2yr old so the faster she can have her mommy back the better that is with me. I am a stay at home mom so I don't have to worry about going back to work or school, but getting better faster would be good for those who do.

I am a binge eater, emotional eater, stress eater, bored eater, I am an everything eater. So with that being said the DR just said no RNY. I don't know if his reasoning is right but he said people like me with all these eating issues who get RNY WILL most likely gain the weight back and sometimes more. MORE, I started this at 250# and I don't wanna be MORE after going thru a major surgery. I know not everyone gains back their weight with RNY, but geeze the number that do is a whopper. I have been 315# before, when I was pregnant. After giving birth I was 290#. No thank you I don't want to be there ever again in my life.

I believe he was fighting for me to get the sleeve because he is new to sleeving and wants me to be his poster girl. All the more power to him then, that means he will really want me to succeed. This is a fairly new procedure, and he has no doubts that I will do phenomenal. He has so much faith in me and the sleeve that I actually want to do it, I have no hesitation or doubts. Who am I to argue with a guy who cuts people open for a living right lol.

Plus the added bonus for me is since I originally wanted the RNY he said he will make my new stomach the same volume size he would make a RNY patients. And also if I hate the VSG he can revise it to a RNY for me. I can't go wrong with the sleeve in my eyes.

Don't let insurance push you around. I don't know your circumstances but MANY MANY people on here say they get denied the first time around. It's like the insurance companies like to test you or something because once you appeal they usually say yes. There are a lot of people on here who would be willing to help you and support you, so don't be too worried. Just keep doing research about everything, including the insurance process. I find the more I know the better I feel walking into a situation.

Good Luck and keep us posted.

[hadouni 301]

Tiffykins- Thank you for your post - all of you really, thank you.

I'm in the same boat (almost) as GypsyMom and am almost certain I want to do the sleeve but there is a little voice in the back of my head chanting "sugar junkie" that just won't let me fully commit to the sleeve yet. Surgeon told me it was my choice he'd do GB, VS or Lap based on my health. I'm scheduled for an endoscopy on 10/27 and I suppose that could produce results that would push me in one direction or the other. I believe my insurance will cover any of the three so I'll be ok with VS or GB if I'm pushed medically in one direction or the other.

Here's a question for the mom's: I'm a single mom with a 3yr old. How long will I need help from my mom on a daily basis? I won't be able to lift him for a while (week, two weeks?) but anything else I should worry about?

Thanks!!

[GypsyMom 0]

Thank you ALL for your wonderful replies. It really eases my mind when I get to hear experiences from other who have had it done or were in my position before. So it is greatly appreciated. I should hear back today or tomorrow about the details of my insurance coverage. The Dr. Office is calling them to find out specifics since they don't want to seem to give me much information when I call. They have been rather vague with me. I almost feel like, as soon as I mentioned weight loss surgery, all of a sudden their attitudes changed. Oh well... I don't care what they think. As long as I get approved I am fine. lol Oh and I have 3 kids. But never got my tubes tied because I was still young and wasn't 100% sure how I felt about having one last child. Still not sure. My husband and I jump back and forth on that subject. But it is nice to know that just in case we did want another child or had an unexpected pregnancy that I wouldn't have to worry much with the VSG after 18 months. Well.. I am excited for this journey. Just wish I didn't have to wait 6 months! I know they will go fast but when you are actually waiting for something they tend to feel like they go slower then usual.