Should I switch to RNY?

[sleevegirl88 54]

@Screwballski that dinner sounds delicious btw lol... i'm just so torn as i know sleeve is irreversible i'm just wondering what the percentage of sleeve revising to RNY v RNY to sleeve revision percentages are? and i do worry about GERD but also know a lot of people have had the hernia repair while under and been fine ;/ just kind of a catch 22 im hoping it will help mine either way i go

[sleevegirl88 54]

@Matt Z im considering the RNY with some of the research as a possibility i was just more set on sleeve as it does remove the part of the stomach where ghrelin is released.. my issue which ive been working on now is the always feeling hungry and its why originally i was dead set on sleeve and im trusting my surgeon with where he says which ever i choose he supports HOWEVER im scared of living with heartburn and it getting bad after sleeve but like i mentioned before i dont have it now except for when i eat fried foods which i dont plan to eat afterwards but if there's the chance it could be worse down the road then.. idk... just caught between a rock n hard place

[Matt Z 4,139]

2 minutes ago, sleevegirl88 said:

@Matt Z im considering the RNY with some of the research as a possibility i was just more set on sleeve as it does remove the part of the stomach where ghrelin is released.. my issue which ive been working on now is the always feeling hungry and its why originally i was dead set on sleeve and im trusting my surgeon with where he says which ever i choose he supports HOWEVER im scared of living with heartburn and it getting bad after sleeve but like i mentioned before i dont have it now except for when i eat fried foods which i dont plan to eat afterwards but if there's the chance it could be worse down the road then.. idk... just caught between a rock n hard place

I understand, when I was talking with my surgeon about getting my band out and revising, I was leaning towards the sleeve as well. But, I ended up going with the Bypass. My surgeon won't do band to sleeve revisions due to increased rate of staple line failure due to the scar tissue created by the band. She would have sent me to another surgeon in her practice if I *really* wanted it, but she wouldn't do it. She installed my band, and I was really looking forward to having her do my removal and revision because of how skilled she is, so this really set me back. I originally turned my nose up at the bypass, for all the wrong reasons, because I was provided with incorrect or incomplete information when I asked around this site. It wasn't until I started doing my own deep dive into the reality of the surgery that I realized there was more myth and false information spinning around. I can say, that I'm absolutely tickled I decided to go with the bypass.

The Ghrelin thing, is another topic that's not fully researched, not everyone loses the hunger sensation, and then, MOST folks regain it down the road. I'm over 6 months post op from the bypass, and my hunger sensation is TOTALLY different than before hand. Will that change? Maybe, but at this point, I've been able to really isolate the "head hunger" vs "real hunger" thing.

Not everyone gets GERD issues post sleeve. But, that's one thing that is pretty much NOT going to happen with the bypass, due simply to the new layout. Does each have their pros and cons... clearly. I can only provide you with facts as they are, my experience, my knowledge from my own research and let you take the reigns from there.

Sleeve to RNY revision happens a decent amount (I've got a friend of mine, like a IRL friend that had to get his sleeve revised to rny just a few months ago), there are RNY to Sleeve revisions, but those are *VERY* far and few between, you'll see Band over Bypass revisions more than you'll see RNY to Sleeve revision.

Either way, research EVERYTHING and make the most informed decision you can based on your situation.

Good luck! If you have any questions or follow up or just want to chat, shoot me a PM.

[CrankyMagpie 509]

RNY-to-sleeve revisions happen, but it's apparently mostly because of severe reactive hypoglycemia and other really weirdly specific complications.

Sleeve-to-RNY is more common in part because the sleeve was eventually conceived as a safer surgery to give people with much higher BMIs, with the intention of converting them to RNY once they lost enough weight that that was a safe option for them. They started doing it as a standalone procedure when many of those patients opted not to come in for the second surgery, being successful with just the sleeve. But sleeve-to-RNY absolutely does happen, still, especially for people who have uncontrolled GERD or who can't lose enough weight with the sleeve alone.

In my pre-op testing they found some small lesions in my esophagus, which might have been esophagitis or might have been a small amount of GERD. I went with the sleeve despite that, because I also have arthritis and might need to take ibuprofen and other NSAIDs again, ever, in my life. (Also, I had been taking large amounts of NSAIDs over a long period of time, and they may have been responsible for some of the damage they found.)

I can't tell you how that turned out for me, since I'm only a week post-op, but I will say my doctor didn't try to sway me toward RNY at all, and given that I also had a hernia repaired, I'm pretty hopeful that it'll all turn out OK.

[Foxbins 625]

I had my sleeve in 2011. I didn't have GERD before the sleeve, mine developed about 18 months after surgery. However, I still don't have any hunger and for me, the tradeoff of no hunger + GERD was worth it.

[sleevegirl88 54]

@CrankyMagpie let me know how it turns out and keep me posted!

@Foxbins is it pretty manageable with heartburn meds?

[Briswife15 890]

Jumping in here just to add that I'm pre surgery but because I have GERD and the barium swallow showed a decent amount of reflux and dismobility my surgeon won't do a sleeve for me. He says the sleeve makes GERD worse. I've heard it said on these boards that the sleeve us a high press system. Good luck with whichever procedure you choose!

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[sleevegirl88 54]

@Briswife15 thanks, i really appreciate my final follow up is next Wednesday and that's when i have to give my final answer so i really appreciate it!

[Screwballski 540]

On 10/09/2018 at 13:07, sleevegirl88 said:

@Screwballski that dinner sounds delicious btw lol... i'm just so torn as i know sleeve is irreversible i'm just wondering what the percentage of sleeve revising to RNY v RNY to sleeve revision percentages are? and i do worry about GERD but also know a lot of people have had the hernia repair while under and been fine ;/ just kind of a catch 22 im hoping it will help mine either way i go

I’m not invested in either surgery. I only know what’s working well for me. If something changes, my surgeon already has a plan in place. I really had no clue whether I’d wake up to a bypass or sleeve. He told me my long term comfort was going to come first, then my desire for a sleeve would be considered.
Regarding the meal: It was fabulous! I was unable to finish either the rib or the meatball. I got full right away! (Because I got greedy and ate one grape first.). I love this sleeve! Also, my lips were on fire after the first bit of the rib. 😄

[catwoman7 11,212]

5 hours ago, CrankyMagpie said:

RNY-to-sleeve revisions happen, but it's apparently mostly because of severe reactive hypoglycemia and other really weirdly specific complications.

Sleeve-to-RNY is more common in part because the sleeve was eventually conceived as a safer surgery to give people with much higher BMIs, with the intention of converting them to RNY once they lost enough weight that that was a safe option for them. They started doing it as a standalone procedure when many of those patients opted not to come in for the second surgery, being successful with just the sleeve. But sleeve-to-RNY absolutely does happen, still, especially for people who have uncontrolled GERD or who can't lose enough weight with the sleeve alone.

In my pre-op testing they found some small lesions in my esophagus, which might have been esophagitis or might have been a small amount of GERD. I went with the sleeve despite that, because I also have arthritis and might need to take ibuprofen and other NSAIDs again, ever, in my life. (Also, I had been taking large amounts of NSAIDs over a long period of time, and they may have been responsible for some of the damage they found.)

I can't tell you how that turned out for me, since I'm only a week post-op, but I will say my doctor didn't try to sway me toward RNY at all, and given that I also had a hernia repaired, I'm pretty hopeful that it'll all turn out OK.

you're thinking of sleeve to DS. The sleeve at one time was phase 1 of a DS, but it later became a standalone surgery

[CrankyMagpie 509]

24 minutes ago, catwoman7 said:

you're thinking of sleeve to DS. The sleeve at one time was phase 1 of a DS, but it later became a standalone surgery

No, it was also a first phase of the RNY. https://link.springer.com/article/10.1381%2F096089203322618669

You are right that I should have included that it was a precursor to DS, though. This article refers to both: https://www.sciencedirect.com/science/article/pii/S2444866416300186#bib0365

[catwoman7 11,212]

28 minutes ago, CrankyMagpie said:

No, it was also a first phase of the RNY. https://link.springer.com/article/10.1381%2F096089203322618669

You are right that I should have included that it was a precursor to DS, though. This article refers to both: https://www.sciencedirect.com/science/article/pii/S2444866416300186#bib0365

hmmm....thanks. I'd never heard of that before.

[NYJenn 1,463]

Bypass!

[GreenTealael 25,336]

8 hours ago, sleevegirl88 said:

@Matt Z im considering the RNY with some of the research as a possibility i was just more set on sleeve as it does remove the part of the stomach where ghrelin is released.. my issue which ive been working on now is the always feeling hungry and its why originally i was dead set on sleeve and im trusting my surgeon with where he says which ever i choose he supports HOWEVER im scared of living with heartburn and it getting bad after sleeve but like i mentioned before i dont have it now except for when i eat fried foods which i dont plan to eat afterwards but if there's the chance it could be worse down the road then.. idk... just caught between a rock n hard place

I have the sleeve and experience real hunger, not head hunger. It does not always lessen in intensity or go away completely, so you may want to have that in the back of your mind... Whatever you choose, we support you!

Edited October 10, 2018 by GreenTealael

[JohannaLea 0]

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.

I have been reading everything i can get my hands on. One post from a sleeve patient talked about her weightloss slowing soon after surgery and she could not understand that because even the cheesecake she eats is in small portions. Also said she does not hsve a problem with soda like she thought she would. Why go through all that and not care.

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