Should I switch to RNY?

[sleevegirl88 54]

So my surgeon is leaving the decision to me but on my barium swallow i showed slight GERD not a significant amount but some..... I normally don't suffer from GERD unless i eat fried foods which cant eat those after surgery anyways... well i've been doing research on RNY vs Sleeve and originally I set out to have the sleeve but i see a lot of RNY patients bashing it b/c they say people don't really lose the weight and gain it back... is that just due to people making poor choices on food late or not enough exercise? or should i reconsider? sorry I am super nervous and just rethinking switching but i wonder if i was just hearing biased opinions from RNY patients...I would like to know if Sleeve patients have had just as good luck with weight loss by doing the things they should or would be honest and say they gained bc they made poor choices...(sorry for ranting)

some facts that may help any advice:

starting weight 255 at 5'7 tall--- 40 bmi

I do have under active thyroid problems but that's it

[mousecat88 2,280]

I'm having bypass, but I can tell you a friend of mine had the sleeve 3 months ago and has already lost 50lbs. He hasn't had any issues and is extremely happy with it. My surgeon recommended bypass for me because I already have pretty bad acid reflux. I heard that GERD can get worse if you already have it - but if your surgeon doesn't seem that concerned as to make a recommendation one way or the other, I wouldn't stress.

[sleevegirl88 54]

@mousecat88 thanks this makes me feel a little better!

[KimTriesRNY 1,853]

Anyone can gain due to bad habits. It doesn’t matter what surgery the person had. Lots of sleevers here had good success.

You do see a lot of people posting about regain, but most times this is due to noncompliance with diet and exercise and has nothing to do with whatever surgery someone had.

[sleevegirl88 54]

@KimTriesRNY thanks.. ive seen alot of success with both and mostly people saying they didnt lose or gained back say it wasnt to poor choices but left me wondering if maybe they just didnt want to admit it

[GreenTealael 25,352]

I would switch if there was even a sign of GERD(I love my sleeve, i only say this because I want everyone to be safe, healthy & have the best possible outcome)

They are all just tools, some people use them better than expected, others genetically get the short end of the stick, with wide range of performance in between. Go with your instincts.

Safe Journey

[sleevegirl88 54]

@GreenTealael thanks i really appreciate the encouragement

[Ed_NW 684]

My sister-in-law had RNY over 10 years ago and she is still doing really well. Of the two surgeries, RNY is the gold standard and has the best results long term. You never hear of someone going in for a revision from RNY to sleeve, just saying.

[YeahOkay31 651]

Both surgeries can fail if you don't follow your plan, adopt a healthier lifestyle, and tame those demons. I have seen sleeves gain their weight back, I have seen bypasses gain their weight back. It has much more to do with compliance overall. I have lost 84 pounds in a little over five months with a sleeve--but I follow my plan 90% of the time. You should never expect your tool to do all the work, so just keep that in mind.

As for the GERD, I had very slight issues before the my sleeve, I had a hiatal hernia so my surgeon figured repairing that would cure any GERD and I would be okay. Sadly, my GERD is pretty bad now, I take 40mg of Nexium everyday plus maybe 2-6 tums a days depending on how bad the pain is. I have a lot of break through pain even with meds. This would be the only reason I would advise looking into the RNY more carefully. Long term use of PPIs are not very safe.

Good luck with whatever surgery you chose!

[sleevegirl88 54]

@YeahOkay31 thats kind of what he is betting on too.. they found a small hernia and was hoping with repair it would be better... with your GERD is it an all the time thing or more just triggered by certain foods for you?

[YeahOkay31 651]

Just now, sleevegirl88 said:

@YeahOkay31 thats kind of what he is betting on too.. they found a small hernia and was hoping with repair it would be better... with your GERD is it an all the time thing or more just triggered by certain foods for you?

Unfortunately, it is an everyday thing no matter how bland I eat. If I don't take my nexium I am in trouble. However, the tum consumption depends on what I am eating. Like I had chili last night so I am popping tums like a fiend today.

[Matt Z 4,139]

I'm going to back @GreenTealael on this one, if you've got even the slightest GERD now... the sleeve will more than likely make it worse. Side note that people seem to get wrong (not that you stated this either way, just some information that most folks don't have correct) is that the sleeve is non-reversible under ANY circumstances, You can be revised from Sleeve to RNY, but you cannot be reversed from the sleeve. The bypass... is reversible, it is risky, and it doesn't happen too often, but it DOES happen. Something to think about. Sleeve, 90% of your stomach ends up in the medical waste bin... Bypass, everything is still in there, the stomach is split but just the connections have been adjusted, nothing is actually removed.

[Screwballski 540]

On 10/09/2018 at 11:36, Matt Z said:

I'm going to back @GreenTealael on this one, if you've got even the slightest GERD now... the sleeve will more than likely make it worse. Side note that people seem to get wrong (not that you stated this either way, just some information that most folks don't have correct) is that the sleeve is non-reversible under ANY circumstances, You can be revised from Sleeve to RNY, but you cannot be reversed from the sleeve. The bypass... is reversible, it is risky, and it doesn't happen too often, but it DOES happen. Something to think about. Sleeve, 90% of your stomach ends up in the medical waste bin... Bypass, everything is still in there, the stomach is split but just the connections have been adjusted, nothing is actually removed.

To be fair Matt, it’s 6 of one and half a dozen of the other. Neither is reversible. They become variations of each other when you make the switch to/from.

[Screwballski 540]

On 10/09/2018 at 09:19, sleevegirl88 said:

So my surgeon is leaving the decision to me but on my barium swallow i showed slight GERD not a significant amount but some..... I normally don't suffer from GERD unless i eat fried foods which cant eat those after surgery anyways... well i've been doing research on RNY vs Sleeve and originally I set out to have the sleeve but i see a lot of RNY patients bashing it b/c they say people don't really lose the weight and gain it back... is that just due to people making poor choices on food late or not enough exercise? or should i reconsider? sorry I am super nervous and just rethinking switching but i wonder if i was just hearing biased opinions from RNY patients...I would like to know if Sleeve patients have had just as good luck with weight loss by doing the things they should or would be honest and say they gained bc they made poor choices...(sorry for ranting)

some facts that may help any advice:

starting weight 255 at 5'7 tall--- 40 bmi

I do have under active thyroid problems but that's it

I was a band to Sleeve revision in May. I had slight GERD, even with my band because it had been faulty for over 12 years. My surgeon wanted to do RNY, I really felt strongly that I wanted a sleeve. In the end, we decided to do the sleeve if it was possible when he saw what was going on inside.
I woke up to a sleeve.
I couldn’t be happier. I took PPI’S for the first 90 days while stomach healed, like most patients. I’ve been off them now for a couple weeks. Not a single issue. I had a jalapeño meatball and a Buffalo glazed rib at a gourmet taster event Saturday. No Tums required. 👍🏻🙂.
Your stomach may be quite different.

[Matt Z 4,139]

24 minutes ago, Screwballski said:

1 hour ago, Matt Z said:

I'm going to back @GreenTealael on this one, if you've got even the slightest GERD now... the sleeve will more than likely make it worse. Side note that people seem to get wrong (not that you stated this either way, just some information that most folks don't have correct) is that the sleeve is non-reversible under ANY circumstances, You can be revised from Sleeve to RNY, but you cannot be reversed from the sleeve. The bypass... is reversible, it is risky, and it doesn't happen too often, but it DOES happen. Something to think about. Sleeve, 90% of your stomach ends up in the medical waste bin... Bypass, everything is still in there, the stomach is split but just the connections have been adjusted, nothing is actually removed.

To be fair Matt, it’s 6 of one and half a dozen of the other. Neither is reversible. They become variations of each other when you make the switch to/from.

I'm sorry, but the Bypass **IS** reversible. It doesn't happen often, but it certainly does happen. There has been, at least 1 member here in the last, month or so that was approved for RNY reversal.

And to be clear, I am fully aware of the process for revisions. I'm specifically stating, that the bypass *CAN* be reversed, under special circumstances, that *HAVE* happened to at least 1 member of this site within the last month or so, whereas the sleeve *CANNOT* be reversed, under any circumstances.

And a quick google for "RNY Reversal"
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4196428/

https://www.soard.org/article/S1550-7289(14)00472-9/abstract

Conclusions

Reversal of RYGB to normal anatomy is reasonable in patients with severe or refractory complications.

Edited October 9, 2018 by Matt Z