undecided?
- Thread starter TMannon
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Cynthia513
Member
My surgeon recommended the Roux en Y because of my GERD. We ended up doing the sleeve because I have other issues. If you have concerns, your surgeon can help you make a choice that will be helpful.
dianeseattle
Member
Is it Tammy? Sorry, I can't maneuver easily because i have a cast on my hand the size of my head.
Welcome to the group.
SURE, i'll stick my neck out here. And someone will disagree with me. That's always good.
GERD is GastroEsophageal Reflux Disease. We all need to READ AND KNOW about it. In so doing, we become informed consumers.
We are most willing to offer opinions but there are no doctors here, though we do have a few nurses. Still, we're just people with opinions, largely based on our experiences. Don't take those at face value. Do your research. You are looking at MAJOR surgery that will change your digestive system forever. You can never grow your stomach back. So find out all you can before you commit.
The VSG (sleeve) essentially removes your entire stomach and a small pouch is fashioned out of the esophagus and small intestine that remain. You don't have digestive functions that used to be located in your stomach.
RYGB (Roux-en Y Gastric Bypass) cuts away 80 percent of your stomach, but leaves the rest of the organ in your body. As such, you will still have certain small amounts of the enzymes and juices, but your pouch doesn't benefit from it. A small part of the jejunum, or top of the small intestine, is divided into a Y and the top part is attached to the pouch that's left, bypassing the duodenum. the other arm of the Y is stitched farther down the small bowel where it empties directly without much absorption of calories or nutrients, but contains the remaining enzymes and acids.
RYGB can be reversed because your old stomach is still in your body. VSG (sleeve) cannot because the stomach is removed.
Both procedures are effective in some ways. From ASMBS: "... the rerouting of the food stream [in RYGB] produces changes in gut hormones that promote satiety, suppress hunger, and reverse one of the primary mechanisms by which obesity induces type 2 diabetes."
The sleeve has the potential for more early complications as well as long-term vitamin deficiencies , and cannot be reversed.
In either event, make sure you take vitamins and mineral supplements for the rest of your life. As Bluelady has pointed out here, B vitamins are ESSENTIAL, and not getting enough B1 can ruin your health.
I'm still evaluating the duodenal switch, but it sounds promising. still, its potential complications are very serious.
i've probably left stuff out here and gotten some things wrong, but i'm not advising you. i'm only giving you my opinion based on a handful of medical facts. I had RYGB and my results are as good as those found in the DS and have been for 12 years.
a business advisor once told me i should be able to recite my business plan by heart, and he was right. i believe you should be able to recite everything about your surgical choice by heart, too. if you can't, why are you doing it? what are your expectations? what are the warning signs?
Do your homework, then speak to your surgeon about specific things you have learned, especially if you need clarification.
it still bugs me after all these years that i can't find a definition for "Roux-en." The Y, I understand. But in French, Roux-en means Redheaded in, and i just don't get it. Also, if you make a roux in the kitchen, you are just cooking flour in slightly browned butter prior to making a bechamel sauce. Are they speaking a different language?
Now, go to your seminar and blow them away with your questions. The more informed you are, the more respectful and attentive they will be. Own it!
Welcome to the group.
SURE, i'll stick my neck out here. And someone will disagree with me. That's always good.
GERD is GastroEsophageal Reflux Disease. We all need to READ AND KNOW about it. In so doing, we become informed consumers.
We are most willing to offer opinions but there are no doctors here, though we do have a few nurses. Still, we're just people with opinions, largely based on our experiences. Don't take those at face value. Do your research. You are looking at MAJOR surgery that will change your digestive system forever. You can never grow your stomach back. So find out all you can before you commit.
The VSG (sleeve) essentially removes your entire stomach and a small pouch is fashioned out of the esophagus and small intestine that remain. You don't have digestive functions that used to be located in your stomach.
RYGB (Roux-en Y Gastric Bypass) cuts away 80 percent of your stomach, but leaves the rest of the organ in your body. As such, you will still have certain small amounts of the enzymes and juices, but your pouch doesn't benefit from it. A small part of the jejunum, or top of the small intestine, is divided into a Y and the top part is attached to the pouch that's left, bypassing the duodenum. the other arm of the Y is stitched farther down the small bowel where it empties directly without much absorption of calories or nutrients, but contains the remaining enzymes and acids.
RYGB can be reversed because your old stomach is still in your body. VSG (sleeve) cannot because the stomach is removed.
Both procedures are effective in some ways. From ASMBS: "... the rerouting of the food stream [in RYGB] produces changes in gut hormones that promote satiety, suppress hunger, and reverse one of the primary mechanisms by which obesity induces type 2 diabetes."
The sleeve has the potential for more early complications as well as long-term vitamin deficiencies , and cannot be reversed.
In either event, make sure you take vitamins and mineral supplements for the rest of your life. As Bluelady has pointed out here, B vitamins are ESSENTIAL, and not getting enough B1 can ruin your health.
I'm still evaluating the duodenal switch, but it sounds promising. still, its potential complications are very serious.
i've probably left stuff out here and gotten some things wrong, but i'm not advising you. i'm only giving you my opinion based on a handful of medical facts. I had RYGB and my results are as good as those found in the DS and have been for 12 years.
a business advisor once told me i should be able to recite my business plan by heart, and he was right. i believe you should be able to recite everything about your surgical choice by heart, too. if you can't, why are you doing it? what are your expectations? what are the warning signs?
Do your homework, then speak to your surgeon about specific things you have learned, especially if you need clarification.
it still bugs me after all these years that i can't find a definition for "Roux-en." The Y, I understand. But in French, Roux-en means Redheaded in, and i just don't get it. Also, if you make a roux in the kitchen, you are just cooking flour in slightly browned butter prior to making a bechamel sauce. Are they speaking a different language?
Now, go to your seminar and blow them away with your questions. The more informed you are, the more respectful and attentive they will be. Own it!
Last edited:
eladams2015
Member
As someone who had sleeve with a surgeon that was not forthcoming with information on the high incidence of GERD and just had to have a revision to RNY as a result, I would say the surgeon is giving you sound advice!
dianeseattle
Member
I'm not criticizing you. I make typos too, especially when I'm not criticizing you. I make typos too, especially when I am voice typing like I am right now. I see that my computer has just duplicated what I said twice and I'm not even going to bother to go back and edit. I just pointed out your error because I wanted to make a point about being informed.
TraceyT
Member
T -
In some cases bypass can help / clear it up. I have GERD and had RNY Bypass 1/22/2020. I take daily medication for the GERD. My surgeon said I'd probably take the medication for few months. It may be resolved - it may not be. It seems to be a better possibility for it being resolved with RNY Bypass than the sleeve. Regardless of the type of surgery you have - there are no guarantees that any medical issues will be resolved.
Some people who are diabetic come off of all their meds shortly after surgery. Others may have to continue medication for months - years - or their lifetime.
Best of luck on your new journey!
In some cases bypass can help / clear it up. I have GERD and had RNY Bypass 1/22/2020. I take daily medication for the GERD. My surgeon said I'd probably take the medication for few months. It may be resolved - it may not be. It seems to be a better possibility for it being resolved with RNY Bypass than the sleeve. Regardless of the type of surgery you have - there are no guarantees that any medical issues will be resolved.
Some people who are diabetic come off of all their meds shortly after surgery. Others may have to continue medication for months - years - or their lifetime.
Best of luck on your new journey!
I finally got my appointment to see the Dr. I am so excited !!!!!!!Thank you I have been reading a lot and Im really leaning toward the bypass
Stacey Cranfill
Member
Hello and Thank You for describing the differences. I am doing all my legwork comparing bariatric surgeries and hearing from folks who have had the surgery. There is a lot to consider. Thanks again for your post.
Also found this on Wikipedia:
Why is it called Roux en Y?
The name is derived from the surgeon who first described it (César Roux) and the stick-figure representation. Diagrammatically, the Roux-en-Y anastomosis looks a little like the letter Y.
dianeseattle
Member
Thank you for doing that research Stacey and welcome to the group from me, just in case everyone else welcomed you while I was gone. This is my chance to say howdy. That is the most logical and clear explanation for the the surgical procedure I've ever read.
What kind of time frame are you hoping for now? And what stage of the decision process are you at?
What kind of time frame are you hoping for now? And what stage of the decision process are you at?
Oceansblue205
Member
How do you feel? I’m scared. I know of two people who died a couple years after having the surgery. My mom told me not to do it. I know I’m grown but sometimes you have to listen to your parents. I’m trying to find someone who has had it around 15 to 20 years. I know about side effects. I had the lapband removed October of last year and it cause my body to have a hiatal hernia and GERD. I have painful hunger pains. It’s weird. But I’m still researching. Are you happy with it so far?
Jennifer
Jennifer
eladams2015
Member
I had a band originally, and converted to sleeve - HORRIBLE GERD... I wish I had done bypass at the first revision, but I ended up having to get one in August. Not a single time of having GERD since! I am SO SO SO happy with the change to bypass. While I wish it were not another surgery, I can eat normally again, I don't have to sleep propped up to avoid choking at night.. everything works as it should now.
dianeseattle
Member
Welcome to the group, Jennifer. It's good that you're asking for personal experiences because there are mixed results among surgeons.
However, the risk of death in RYGB surgery is tiny. Tiny tiny. That's a fact and you can look it up on federal websites like NIH or from scholarly medical institutions like Mayo Clinic, among others. I've found Bariatric Surgery FAQs | Patients | ASMBS to be pretty dependable. It was the first site I visited that explained the Duodenal Switch.
The first thing you need to think about is risk, and risk is almost always based on a patient's comorbidities and weight. Diseases that come with obesity include heart disease, diabetes, cellulitis, sleep apnea, hiatal hernia, GERD and a dozen others I can't think of right now. So if you want surgery, you will work closely with a bariatric medical team whose goal is to get you surgery-ready. Even for healthy persons, stroke under general anesthesia is a real risk. The more you weigh, the more your breathing is compromised and the greater the possibility you could die.
These days surgeons insist their patients lose a significant amount of weight before surgery. Some people here have said they had to drop 10% of their current body weight. But there's a more important reason for the weight loss requirement: you have to demonstrate that you are capable of following a healthy eating plan for the rest of your life. If your doctor doesn't mention the weight-loss requirement, I'd give serious thought to finding a different surgeon who will.
I don't know if the people who died were obese or superobese and/or had underlying comorbidities that would have killed them eventually. The irony of that is that if you don't have the surgery, you will probably die sooner from another disease, but you can't have the surgery if your surgeon sees your underlying disease as a danger during surgery.
You had a lap band, so you are more than casually aware of weight-loss surgery (WLS). I had RYGB on August 20, 2007, and that's almost 13 years ago. I have no comorbidities at all and I live a normal, healthy, active life. There are people who've visited here who had surgery 20 or more years ago, but their experiences were mixed, based on how sophisticated the technology has become, and the oversight that has weeded out the quacks.
I'm biased, but I think RYGB using an open procedure is the best way to go. Healing from the incision was painful, but sometimes you just have to bite the bullet and stand your ground. I recommend the open procedure because I just don't see how a surgeon could easily perform this complex surgery, regardless of his/her skills, if it's done laparoscopically. Now, a number of people here will likely tell you the opposite. That's why I couched my opinion in my personal bias. Reading other stories, I usually find that people have a lot more problems and pain after surgery if it's not done with an open procedure.
Also, if you choose RYGB, they do NOT remove the stomach organ. They simply cut out part of it to turn into a pouch and do the bypass, but if it fails or causes trouble, RYGB is reversible. VSG is not because the stomach is removed. Also, member here will tell you that VSG is not a good choice if you have GERD. It doesn't help and often gets worse.
It is true that in any procedure, the part of the organ that manufactures grehlin, the hormone that causes insane cravings, is removed or separated from the pouch. Although people here will tell you that they still have cravings, I can honestly tell you I don't. It still takes me an hour to eat dinner and even my hunger pangs are hard to find. Last night, not only did it take me an hour, but I also spent many more hours waiting to get rid of teh "full" feeling.
My only regret about having WLS is that I didn't do it when I was younger. I lost so many years to obesity, and suffered from high blood sugar, GERD, and a social stigma that was almost as painful as the physical pain and problems.
And it literally is true that if you ramp up to the surgery as required by your surgeon, your nutritionist and your team. when you go into the hospital, they'll sedate you a little, then put you under, and the next thing you'll hear is your name being called as you are woken up. It seems like only a minute has passed, but you only have to recover from the anesthesia and work the gas out of your system, and you're good to go.
I know you're scared, and I think if you have a really big panicky feeling, you shouldn't have the surgery until you have spent a few months with your surgical team, getting prepared for your new life. I would have this surgery over and over again. And I'd recommend it to anyone who's tried so hard and failed so often to get healthy when honestly, surgery was the only real option.
Brenda2010
Member
I love everything you wrote here Diane but I have to express my own bias about having RYGB laparoscopically. Unless there is a difficulty, this is always my surgeon's go-to. I was also lucky to have a high-tech experience where she actually preformed it robotically. My incisions were tiny, I had virtually painless healing and a very smooth recovery. Could be that because my surgeon who is in her mid-40s, learned the procedure this way and is most comfortable with it. Just one gal's opinion.
dianeseattle
Member
Thank you for speaking up Brenda, and it's wonderful that you had such a positive and cutting-edge procedure. I hope others will share their experiences as well.