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doc wants me to have bypass



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saw a new surgeon. having an upper GI then endoscopy done first week of april. band has been very tight this week. part of my issues. doc wants me to consider bypass and not the sleeve. thinks i will have better results....very fustrated..

~Kristen

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It's ultimately up to you. He will do the surgery you want. For me personally I didn't want the malabsorption. I did this surgery to be healthier, and I don't believe that the bypass is a healthy choice because of the malabsorption. Good luck!

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Medicare would have paid for the bypass surgery but I chose self pay because my doc thought it would be safer for me and I didn't want the malabsorption either! Have had that when I ate too much lettuce, or certain raw veggies. Also had a lactose intolerance before surgery and didn't want to mess with my intestines. Have had no problems with either since the sleeve... Doesn't mean I won't when I can eat more as I'm 4 months out now.

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My doc said I was a candidate for either, but would likely have better results with RNY, at least statistically. At first, I was swayed by that, not wanting to have surgery and poor results. But as I thought about it, I just couldn't get comfortable with the idea, and I decided it just was not a good option for me. I don't like the malabsorption, and also that you can never take NSAIDS again.So far, it was a good choice for me.

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What are the reasons why he thinks bypass is a better choice? Maybe you should get another opinion? Do your research!

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My doctor also thinks that RNY is a better option for me. I have bad reflux that prevents him from tightening my band to the level I need for proper restriction. He and I don't think I need malabsorption. His concern is that my reflux will get worse and that I will eventually need to revise to a RNY anyway. He said that the RNY is a "low pressure" system that would virtually guarantee no reflux whereas the sleeve is a "high pressure" system that could make reflux more likely.

He said that 90% of people with reflux have significant improvement after the sleeve, but a small percentage of patients experience reflux that is so bad that a revision to RNY is necessary to prevent esophogeal deterioration and disease.

Given the low percentage of those having to revise to RNY (and the fact that insurance covers revisions), I am going to take my chances with the sleeve.

Best of luck to all.

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I went in asking for bypass, and my surgeon talked me into VSG. So glad that he did. Two reasons: -I am a vegetarian so already have to be careful about nutrient absorption, especailly B12--and RNY as a malabsorptive procedure would have made that even more difficult; 2. -I wanted to be able to take NSAIDs, and while my surgeon allows RNY patients to do so with a PPI after a waiting period, I wanted to be able to take them more liberally if needed, and VSG allows you to do that (I will always take a gastric-protective med though)

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you can eat around both operations......is it that you like sweets and less likely to dump with the sleeve?? that'sthe only reason my surgeon said would be an important....

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I researched allot before getting my sleeve, my final desicion was based on the long term affects of the surgeries. With rounxy and bypass there are malabsortion and stretching of the pouch that can happen so I chose sleeve. My mother also was told by her Doc to get lapband or bypass but I talked her out of it. I'm 3 months out and very happy . Even if I dont loose weight as fast as a bypass or rounxy patient I know eventually all the weight will fall of with no malabsorption problems.

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doc thinks i have bad scar tissue from band issues (constant vomiting). i dont have reflux but my esophagus is already severly dialted. i would prefer the sleeve. and will cont to ask for it.

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My doctor also thinks that RNY is a better option for me. I have bad reflux that prevents him from tightening my band to the level I need for proper restriction. He and I don't think I need malabsorption. His concern is that my reflux will get worse and that I will eventually need to revise to a RNY anyway. He said that the RNY is a "low pressure" system that would virtually guarantee no reflux whereas the sleeve is a "high pressure" system that could make reflux more likely.

He said that 90% of people with reflux have significant improvement after the sleeve, but a small percentage of patients experience reflux that is so bad that a revision to RNY is necessary to prevent esophogeal deterioration and disease.

Given the low percentage of those having to revise to RNY (and the fact that insurance covers revisions), I am going to take my chances with the sleeve.

Best of luck to all.

I too had a problem with acid reflux before surgery. I have had maybe 2-3 times since surgery where I have had to take an OTC acid reducer since surgery 19 months ago. I used to struggle with it at least 2-3 times per week before. I think what helped me is that a lot of the acid pumps are removed along with the portion of the stomach that is removed, cutting down on the acid. I am so thankful not to have the problem anymore, along with all of the other benefits I have had due to the surgery! Best of luck!

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doc thinks i have bad scar tissue from band issues (constant vomiting). i dont have reflux but my esophagus is already severly dialted. i would prefer the sleeve. and will cont to ask for it.

I defiantly would get a 2nd opinion & even a third is sometimes prudent. Your doctor stating you have scar tissue from the band & vomiting could be a serious complication.

I would also ask the doctor how many sleeves he/she has done. It is possible he is so comfortable doing the bypass surgery that when anything is "different" he wants to go to his tried and true method. This is just a thought that popped in my mind.

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thanks everyone! i have my upper gi 4/2 then endo 4/10...i have some other testing in between. will keep everyone updated!

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Hello KMB, I have the same issues that you do, and my surgeon wants to do the bypass too, she explained that the condition of my esphogus and stomach would determine IF the sleeve could be done, she said it's a HIGH PRESSURE area and the connection between the esphogus and stomach may not "hold". I have approval for the sleeve, but I have my fingers crossed that she will be able to do it. It's not always what we WANT, it's what is possible under the circumstances. That BAND did horrible things to me, I wish I would NEVER have done it, but then again, it was a time when I demanded it and even fought with the insurance company about it. I have decided to go with what the surgeon tells me and PRAY, pray alot for wisdom and protection. k

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P.S. this was my 3rd opinion, and each one of them said the same thing. It really does depend upon what they find on the EDG. It's a stupid thing, you have to have complications to get the BAND out, but not enough to limit you to what they can do next. Karen

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