Date 23 April but Bypass or Sleeve?? Questions...

Hi Ladies

Iam a failed sleeve to resectional bypass meaning they took my stomach out all together and made a new one using bis of the bowel. My bypass surgeon is not the idiot that made the sleeve mess. I hope this helps, I suggest you do lots of research, get a 2nd opinion if need be and continue to ak questions as many as you need too.


1. I am concerned with a longer recovery with RnY and going back to work? How long realistically do i need off work as an RN? It is major surgery and if you work in an environment that is anything above sedentry you will probably need 6 weeks.

2. I am worried about future food intake and what I can and cannot tolerate - I dont care if I never eat cake again but I do love fruit and veges. I am also a fish eating vegetarian. I will take to the dietitcian but id love to hear other opinions. I can eat most things but choose to eat mainy protein and about 1/2 cup is all I can manage. Veges need to be well cooked, steak must be tender and juicy and I have sauce or gravy with most things. I can't eat raw veges but can manage tomato or avocado.

3. I am scared of a leak as I have had two lapabands with slippage and having the sleeve might put me at higher risk? There is a higher risk when there has been previous surgery on the stomach. My surgeon does not like to do sleeves when there has been previous issues and the ICU doctors totally supported him as well.
The decision is often based on scarring and how bad that is.


4. I am at higher risk of probems having a bypass than the sleeve anyway. Not sure on this one less than 1% of patient have problems with a sleeve and with a bypass this rises considerably higher to around 20%

5. My BMI is almost 36 - is the RnY overkill? Maybe but 2 failed bands means there are problems so maybe not

6. How likely is it that I will need further surgery in the future with bypass ie. strictures etc if I have a bypass. 25% of patients develop strictures which means endoscopic dilations in day surgery - I had 5 which is very unusual.

7. How bad can the malnutrition problems become with bypass? Within 3 months my vitamin and mineral levels were on the low side. This is monitored closely via blood tests by my GP and dieititian. I have mouth ulcers most of the time which is attributed to a vitamin deficiency but they can't work out which one.

8. My surgeon thought the sleeve but said it was up to me. Said the sleeve is a very easy, run of the mill operation now. His practice does 700 per year and they are a Centre of Excellence. He is the best person to ask but you could always get a second opinion elsewhere.

G

Hi RaniL- I don't know whether to have the bypass or sleeve after band either! I change my mind daily. I've had 2 appointments with my surgeon and one with my GP who had a bypass a few years ago.

1. My surgeon said that hospital and recovery time are very similar. He advises 2 weeks off work to recover. My GP thinks that 4 weeks would be better. I suppose it would depend on what kind of job you had. I think I would be ok, but maybe your job would be more physical and you probably work long hours.

2. There is less chance of a leak compared to sleeve because of a shorter line of stapling or stitches, whatever they are. My surgeon says that bypass complications happen to a very small percentage of people and can get fixed easily, as long as problems are seen to early.

3. My BMI is 40, and Dr Talbot said that he would recommend either surgery for me. He said if I was heavier than I am (God forbid) he would definitely recommend the bypass over the sleeve.

4. I am worried about dumping as well. I've always been a bit of a fainter, and the thought of feeling dizzy and breaking out in a sweat, especially in public worries me a little. I'm not sure about food that is or isn't tolerated. I think I've read somewhere on a forum where someone couldn't tolerate bananas-but am not sure about sweet fruits like berries or grapes etc.

5. My main concern about malabsorption was that because I have poor bone density for my age, and losing weight will make it worse, no matter how it's lost, I was worried after reading some articles saying that bone density deteriotes after WLS, especially with RNY. My doctor has never had a patient that has had bone density issues brought on by the surgery. He said if I take all appropriate vitamins, exercise, have regular dexa scans to monitor bone density, he didn't seem concerned about it. The main concern, which I wasn't really expecting, is that I must drink NO alcohol if having the RNY. That's something that I really should do anyway, long story, but I'm finding the idea daunting.

So, I want RNY because both my doctors have observed better outcomes for weightloss, especially after a band, and less regain over time, and because I won't be able to eat all the things that I shouldn't eat and drink the alcohol that I shouldn't drink which has made me what I am today. But sometimes I want the sleeve, because the idea of NEVER AGAIN freaks me out. I know that I will be committed to doing all right things with sleeve, but unfortunately from my past experience and how I was with the band, I worry that I would relapse with food and alcohol at some point in time- seems to be just what I do. Anyway, so yeah, I'm trying to decide as well! Is there any reason why your doctor didn't think RNY for you? Would be interested to know why, and let me know what you end up deciding

Thanks Elizabeth

I'm 34 yo and have a BMI of 37, I'm having the sleeve. I've never had a band so I can't help u there but I figure I can always go back and have the bypass if I need to so ill start off w this first and give it my best shot.

I have a date, insurance etc is all organised for 23rd April

Here are my concerns:



I think I would be better suited to the RnY as I am a terrible sweet tooth and having that extra tool to help me along would possibly be the difference between sucess and failure. I KNOW that I have a MAJOR role in making this work but the added help would be the best for me HOWEVER:



1. I am concerned with a longer recovery with RnY and going back to work? How long realistically do i need off work as an RN?

2. I am worried about future food intake and what I can and cannot tolerate - I dont care if I never eat cake again but I do love fruit and veges. I am also a fish eating vegetarian. I will take to the dietitcian but id love to hear other opinions.

3. I am scared of a leak as I have had two lapabands with slippage and having the sleeve might put me at higher risk?

4. I am at higher risk of probems having a bypass than the sleeve anyway.

5. My BMI is almost 36 - is the RnY overkill?

6. How likely is it that I will need further surgery in the future with bypass ie. strictures etc if I have a bypass

7. How bad can the malnutrition problems become with bypass?

8. My surgeon thought the sleeve but said it was up to me. Said the sleeve is a very easy, run of the mill operation now. His practice does 700 per year and they are a Centre of Excellence.



Id love to hear from any other revision sleeve to bypass people and why?

Thanks so much everyone...

Rani