Sleeve vs. Bypass with my health situation - upcoming final appt with dr.

[KarenLR75 515]

I have appt this coming week, they are working me in so am not sure what date it will be on - for final meet with dr. I've been working on researching bypass vs. sleeve to make sure that I feel like I concur with what the dr. has suggested. I'm torn on some of the pros/cons of both surgeries based on following about co-morbidities/health situation:

• I do NOT have high blood pressure
• I do NOT have high cholesterol
• I do NOT have diabetes
• I do NOT currently have ongoing heartburn/acid reflux (get heartburn 3 or 4 times a yr, and acid reflux..maybe once a year if that)
• My BMI started out at 60 and is now 54?
• I am 50 yrs old (not young)
• I have long clotting history but NO clotting disorder EVERY episode of clotting (DVT's/PE's) had known causation. Have permanent IVC filter since 2011.
• Knees have severe arthritis and need replacing - have to get to 40 BMI to have kneed surgery

Here are some generalities I've gathered on sleeve vs bypass from searching here, google searches, and many youtube videos watched. If anything is wrong, please let me know. It's amazing that despite how much you read/watch, you can come away with questions still - maybe my retention is shot with long pre-op diet?:

• Bypass – possible chance of bowel obstruction later after surgery
• Bypass – possible chance of twisting bowels after surgery (don't know %)
• Bypass - less chance of reflux/resolves reflux for many
• Sleeve – chance of developing reflux (do not have more than 4 episodes a yr of heartburn, maybe 1 of reflux)
• Sleeve – chances of clots forming in previous ‘stomach/fundus’ area - not able to get specific % (this was also something dr. mentioned)
• Bypass – chances of clots/DVT's? (haven't found specifics yet)
• Bypass vs. Sleeve - Hair loss - tied. Rapid weight loss causes this and can occur with either surgery
• Bypass vs. Sleeve - more long term data on bypass than sleeve
• Bypass vs. Sleeve - overall amt of weight loss tends to even out for both at around 5 to 6 yr mark, but bypass has 10 to 20% greater chance of 'initial faster weight loss"
• Bypass vs. Sleeve - chance for hernias, ulcers, etc. %? for both (need to find out)
• Bypass vs. Sleeve – likely to cause more time in bathroom? Bypass due to dumping/vomiting (some see dumping as a 'pro'?)? Sleeve due to vomiting /diarrhea?
• Bypass vs. Sleeve - % of Vomiting / Amount of Nausea (same?)
• Bypass vs. Sleeve - easier to stretch out sleeve pouch??
• Bypass vs. Sleeve - lesser % of chances or regain with bypass in long term? Statistically significant? True or False?
• Bypass vs. Sleeve - sleeve has more reduction of hunger hormones ghrelin & leptin as fundus removed? Anyone know if bypass has statistically significant reduction in 'unger hormones'?
• Bypass vs. Sleeve - more chance of malnutrition with bypass - what happens with my long term meds & how they will absorb/not absorb (take 2 anti-depressants and 1 is 'slow release' - take 2 diff meds for sleep due to shift work disorder)??
• Bypass vs. Sleeve - bypass surgery longer

Dang..i feel like I'm missing some obvious stuff on this list!!!! Going to go look at snippets saved in Word doc.

Edited June 30, 2019 by KarenLR75
wording

[AZhiker 2,252]

I can definitely tell you that the hunger hormones are greatly if not totally reduced in bypass.

[Panda333 276]

I think this is a comprehensive list and i'm in the same boat as you. I "want" the sleeve due to the less complex nature of the surgery but so many people at least on this board seem to get GERD. Ii'm 48 and have never had that. Worried about the bypass not now but for when I'm older and the nutrution needs. following to see the replies.

[elcee 3,341]

Quote

Trying to compare like that is very hard. I am sure there are an equal amount of side effects and benefits to both. This is why you have a surgeon to discuss it with that should be able to advise the best option for you. For the record most of the extra risk with the bypass is at the time of the op, it is a more complicated surgery than the sleeve so requires a more skilled, experienced surgeon.

I had a revision from band to bypass in Jan and am very happy. I didn’t want a sleeve as i know so many people that have one and the majority seem to have either not had good loss or have major weight gain, I know this is also possible with bypass but I don’t know many people that have one. My surgeon also told me that with my history of reflux he wouldn’t consider sleeving me.

At the end of the day the most important thing is the commitment of the patient. Realise the surgery is only a tool and that success requires hard work.

[Briswife15 890]

I'm 57 and had bypass 3 months ago. I never feel "hungry" like I did before surgery. One of the many reasons I chose bypass is because of the chance of dumping! I had an incredible sweet tooth before surgery and wanted something to deter me. My tastes have changed, and my mental status is such that for now I really only want Protein and food that's good for me. I'm happy I had bypass. Good luck with whichever you choose.

Sent from my SM-N960U using BariatricPal mobile app

[KarenLR75 515]

3 hours ago, Panda333 said:

I think this is a comprehensive list and i'm in the same boat as you. I "want" the sleeve due to the less complex nature of the surgery but so many people at least on this board seem to get GERD. Ii'm 48 and have never had that. Worried about the bypass not now but for when I'm older and the nutrution needs. following to see the replies.

One thing I do know is that 2 of my Aunts had this bpyass surgery in PA back in the day when it was "new"..or at least "new to me"....I'd say early 90's? I can ask. One Aunt to this day has kept her weight off and I was going to call (so has other Aunt but she had a 'surgery re-do' at some point..and ask her how it has impacted both of them long term. They are now in their 70's and every time I have been up there - the whole family is very 'food social' and one Aunt bakes and cooks her hiney off...but she doesn't eat much. So I at least know 2 ppl who had it back in the day when you were cut completely open and docs did not have decades upon decades of experience on long term data.

[KarenLR75 515]

2 hours ago, elcee said:

Trying to compare like that is very hard. I am sure there are an equal amount of side effects and benefits to both. This is why you have a surgeon to discuss it with that should be able to advise the best option for you.

Exactly...but that is also specifically why after doing some more information, is I want to address any remaining questions and also give him any new information about myself that helps him ensure his initial recommendation is still what he feels is best. I also am of a 'trust, but verify' mindset with doctors..all of them, especially specialists.

[KarenLR75 515]

2 hours ago, elcee said:

At the end of the day the most important thing is the commitment of the patient. Realise the surgery is only a tool and that success requires hard work.

This is another thing - doing Keto off and on for years, I've gotten to the point that if I did take a small bite of...a piece of cake..or eat anything that was highly processed or very rich like creamy Italian dishes, it upsets my 'stomach greatly' and I usually spend quite a bit of time in the bathroom.

I like sweets, but I just don't allow myself to indulge in them. I've lost any taste for greasy fast food, I just shudder at the thought. I did 'Opti Fast' back in the Oprah winfrey days and lost 70 lbs and kept if off for a decade. That is one reason the pre-op diet really doesn't bother me that much, there is so much more variety to 'drink' than the 4 to 5 times a day 'shakes' that I drank every single day for almost 4 months.

I realize I did not share with my dr that I have very very mild IBS. Stress and any 'break' from my keto WOL is what brings it out. Not sure that it will matter but I will mention it.

I agree with you, surgery is not the "easy way" out. To me it's a nuclear detonation option...That is why I waited almost 5 years before allowing myself to finally pursue surgery. I had to make sure that I was fully committed to doing the very hard work that remains in front of me. Surgery is a tool, only a tool.

[KarenLR75 515]

1 hour ago, Briswife15 said:

I'm 57 and had bypass 3 months ago. I never feel "hungry" like I did before surgery. One of the many reasons I chose bypass is because of the chance of dumping! I had an incredible sweet tooth before surgery and wanted something to deter me. My tastes have changed, and my mental status is such that for now I really only want Protein and food that's good for me. I'm happy I had bypass. Good luck with whichever you choose

Thank you so much Briswife!! I can definitely understand about desire for the dumping to help ensure compliance, esp with sweet tooth. I watched one woman's youtube videos..she's from TN? And dumping was actually a huge 'PRO' for her with bypass surgery.

Hope your journey is going well in all other aspects too!! I definitely understand about changing tastes and your mental status..it is actually quite a relief in many ways, isn't it?

[New&Improved 1,780]

I chose bypass because it's a more final surgery

It's going to dramatically reduced my diabetes

Weight loss is usually better the first 12 months

I only want the 1 surgery and it is the most restrictive and malabsorptive.

It completely changes your metabolism and internals