Why did you choose the sleeve over bypass?

[goingtothebeach 0]

I was set on getting the RNY until I had my consult yesterday. My doc seems to be pro sleeve, really pushed it. Now I'm confused.

[tinkrbll 23]

My dr chose sleeve for me because I have low Iron and take supplements for it. He said with the bypass, I would be a high risk for having to have iron infusions so that he recommended the sleeve. I took his recommendation since he has been doing this for years. Best thing that has happened to me.
HW 234
SW 218 sleeved 2/6
CW 205
GW 145

[PatientEleventyBillion 851]

My surgeon and two second-opinion surgeons all chose sleeve but did not force me to make a choice. Their arguments stemmed from the following:

- My age (34)

- Despite having stage 3 liver fibrosis and diabetes they were both new and controlled (w/blood workups showing improvements via dietary changes)

- Sleeve can easily later be remedied with a bypass (not an option to everyone, esp those worried about insurance coverage)

- If one ever needs invasive surgery done later in that abdominal region (including liver transplant) the bypass can later cause complications. Those who aren't considered "dire" bypass patients (in a risk assessment bypass is almost always more risky, even if the gold standard) might be coaxed into a sleeve because of it being minimally invasive in comparison - less cuts, less routing, etc.

If it's left up to you, it's your choice. I would ask a lot of questions, especially on if bypass is an option later, both from your surgeon and your insurer if you're going through them.

[goingtothebeach 0]

After the consult I was instructed to verify if my insurance covered the procedure. I had previously seen the requirements for United Health Care and didn't think twice about it, but it's NOT covered under my policy. So I'm considering paying cash. I was wanting to save the money for skin removal later. I'm a single mom, I don't have this money just laying around. So a huge decision on top of it already being a huge decision.

I'm 47,
5'4"
265

Frankly, I feel devastated at this point.

[PatientEleventyBillion 851]

3 minutes ago, goingtothebeach said:

After the consult I was instructed to verify if my insurance covered the procedure. I had previously seen the requirements for United Health Care and didn't think twice about it, but it's NOT covered under my policy. So I'm considering paying cash. I was wanting to save the money for skin removal later. I'm a single mom, I don't have this money just laying around. So a huge decision on top of it already being a huge decision.

I'm 47,
5'4"
265

Frankly, I feel devastated at this point.

I understand, and see your decision is indeed a tough one. Crossing my fingers everything works out.

[goingtothebeach 0]

Thank you.

[brooklyn42 9]

I understand, and see your decision is indeed a tough one. Crossing my fingers everything works out. [emoji20]

Same here single mom n can't cough it up either n mayb have to get my procedure done in July I have used up all my absences I need my job as well as this tool but thing will work out[emoji4]

[teacupnosaucer 445]

I was worried about having lifelong malabsorption issues. I also wanted to live as close to a "normal" life as possible and I didn't feel like the increased chance of food restrictions fit into that vision. I also like the fact that, since I'm only 31, if something happens down the road where I have substantial regain, the option of revising to an RNY is there. (Although I'm hoping I never ever ever get to that point!) I don't have as much weight to lose and think a slower, less drastic weight loss would be just fine for me. It somehow seemed less invasive as a procedure than the RNY. I did have some time there where I seriously doubted my choice (mainly because my surgeon brought up some compelling reasons for having the RNY!) but ultimately I went with my gut... and I want the sleeve.

[brooklyn42 9]

Dr said because of my age 47 the sleeve would be good n I won't be having anymore children [emoji64]

[PatientEleventyBillion 851]

46 minutes ago, teacupnosaucer said:

I was worried about having lifelong malabsorption issues. I also wanted to live as close to a "normal" life as possible and I didn't feel like the increased chance of food restrictions fit into that vision. I also like the fact that, since I'm only 31, if something happens down the road where I have substantial regain, the option of revising to an RNY is there. (Although I'm hoping I never ever ever get to that point!) I don't have as much weight to lose and think a slower, less drastic weight loss would be just fine for me. It somehow seemed less invasive as a procedure than the RNY. I did have some time there where I seriously doubted my choice (mainly because my surgeon brought up some compelling reasons for having the RNY!) but ultimately I went with my gut... and I want the sleeve.

I see you're also in Alberta, would you mind me asking (you dont need to answer if you're not comfortable)

- Do you have any fatty liver or staged fibrosis?

- How long is your liquid diet, in weeks?

- Have you had this weight for a significant amount of time or has it climbed recently?

It's weirding me out the fact that even other people in my group and classes with comparative diseases are only going on a liquid diet for 4-6 weeks at most and I'm forced to 12.

Even though I'm fighting the odds, I have my endoscopy on Monday w/my surgeon and I'll have him look at my liver and see if I can have a new OR date if it's shrunk, or modify diet a little. Doubt they'll do it but worth a shot.

Edited February 26, 2017 by PatientEleventyBillion

[teacupnosaucer 445]

4 minutes ago, PatientEleventyBillion said:

I see you're also in Alberta, would you mind me asking (you dont need to answer if you're not comfortable)

- Do you have any fatty liver or staged fibrosis?

- How long is your liquid diet, in weeks?

- Have you had this weight for a significant amount of time or has it climbed recently?

It's weirding me out the fact that even other people in my group and classes with comparative diseases are only going on a liquid diet for 4-6 weeks at most and I'm forced to 12.

Even though I'm fighting the odds, I have my endoscopy on Monday w/my surgeon and I'll have him look at my liver and see if I can have a new OR date if it's shrunk, or modify diet a little. Doubt they'll do it but worth a shot.

I'd love to answer!

I don't have fatty liver or staged fibrosis. My liquid diet is two weeks. The usual minimum for Dr Gill (my surgeon) is 3 weeks, but he decided due to my current BMI (35) and general good health, 3 full weeks would be unnecessary. I'll find out more details on Monday when I meet with the RD to make my individual plan.

I've been overweight since I hit puberty, and obese since college. I'm only 31, so that puts me at about half my life overweight or obese. Before that I was your normal healthy, active late 80s kid. In the last 5 years after I got pregnant with my first daughter and my PCOS really flared up, I gained 50 lbs despite periods where i did weight watchers and daily cardio workouts. I've been 220lbs or more for the past 5 years, but in this last year after taking the Edmonton weight management courses, starting a swimming routine, and taking meds for my ADHD, I have managed to bring my weight down to ~202 lbs.

That sucks about the 12 week liquid diet, but I have heard of people having to do long ones like that before! I think the longest I've heard of was 16 weeks. I hope after further investigation you're able to get it shortened!

Are you in the Calgary bariatric clinic too? Who's your surgeon?

[PatientEleventyBillion 851]

1 minute ago, teacupnosaucer said:

I'd love to answer!

I don't have fatty liver or staged fibrosis. My liquid diet is two weeks. The usual minimum for Dr Gill (my surgeon) is 3 weeks, but he decided due to my current BMI (35) and general good health, 3 full weeks would be unnecessary. I'll find out more details on Monday when I meet with the RD to make my individual plan.

I've been overweight since I hit puberty, and obese since college. I'm only 31, so that puts me at about half my life overweight or obese. Before that I was your normal healthy, active late 80s kid. In the last 5 years after I got pregnant with my first daughter and my PCOS really flared up, I gained 50 lbs despite periods where i did weight watchers and daily cardio workouts. I've been 220lbs or more for the past 5 years, but in this last year after taking the Edmonton weight management courses, starting a swimming routine, and taking meds for my ADHD, I have managed to bring my weight down to ~202 lbs.

That sucks about the 12 week liquid diet, but I have heard of people having to do long ones like that before! I think the longest I've heard of was 16 weeks. I hope after further investigation you're able to get it shortened!

Are you in the Calgary bariatric clinic too? Who's your surgeon?

Richdeep Gill? LOL. I think we might have the same surgeon.

Edited February 26, 2017 by PatientEleventyBillion

[teacupnosaucer 445]

Just now, PatientEleventyBillion said:

Richdeep Gill? LOL. I think we have the same surgeon.

that's him LOL!

I quite like him. I find him to be very sympathetic.

[PatientEleventyBillion 851]

8 minutes ago, teacupnosaucer said:

that's him LOL!

I quite like him. I find him to be very sympathetic.

Yes. When I did two second opinions because I had wanted the bypass, after meeting with the other two surgeons I then realized my appreciation for having Gill. They say he's a big fan of bypass, but it's clear he's reluctant to do them on people our age, even in my case with advanced liver disease (although mine is controlled and improving).

Is he doing yours in Edmonton? If so I feel bad for him in running back and forth between there and Calgary. I know he has an office in High River, which is where I'm going Monday to see him for my endoscopy.

Edited February 26, 2017 by PatientEleventyBillion

[teacupnosaucer 445]

3 minutes ago, PatientEleventyBillion said:

Yes. When I did two second opinions because I had wanted the bypass, after meeting with the other two surgeons I then realized my appreciation for having Gill. They say he's a big fan of bypass, but it's clear he's reluctant to do them on people our age, even in my case with advanced liver disease (although mine is controlled and improving).

Is he doing yours in Edmonton? If so I feel bad for him in running back and forth between there and Calgary. I know he has an office in High River, which is where I'm going Monday to see him for my endoscopy.

he actually suggested bypass to me initially, as he thought it had the best evidence of long term success since i'm still so young. I just wasn't comfortable with the idea of a bypass, and when I told him he was totally onboard with me doing a sleeve instead. very supportive!

nope, I am travelling to Calgary to him. even though I live basically in Edmonton, the wait list for their program is so astronomically long compared to Calgary's I decided I'd rather just make the drive! it's been a lot of kms, but even with asking for a referral to the Edmonton clinic MONTHS before asking for a referral to the Calgary one, I am on course now to have my surgery in Calgary before even getting my intake appointment in Edmonton. I left myself on the Edmonton waitlist just out of grim curiosity, but will remove myself once I have my surgery. I'm sure somebody else will be overjoyed to take my spot!

i had my scope in High River as well. if you haven't had one before, don't sweat it. the worst part of the whole process is the nasty numbing spray for your throat. you don't remember anything else of the procedure, and you wake up high as hell and they're feeding you muffins! the nurses there are amazingly kind and good at their jobs, too.