I was so set on the sleeve, but doc is pushing bypass...need help deciding!

[jvan71]

Hi everyone. I just found these forums yesterday after my dietician appointment. I was doing some research and stumbled upon this place. I'm really hoping to get some help or "clarification" maybe that will help me make my decision.

I should probably tell you a bit about me and my quest for WLS first. I've been morbidly obese all my life (I'm 39 and was over 200 lbs since about age 18, now am 322) and I started researching WLS about 15 years ago. I'm diabetic (on both insulin and oral meds) and have many other medical problems due to obesity. My mom had gastric bypass about 22 years ago and my dad just had the sleeve last summer.


I noticed that most everyone here seems to be in the UK, so I hope it's ok that I'm here even though I live in the US.

Here are my thoughts on both surgeries:

Gastric Bypass:
Since my mom had gastric bypass 22 yrs ago, I always felt I was familiar with it. I know that she's had lots of vitamin deficiency problems and that this surgery was known for causing this. I've been leery of this surgery because of that.

Sleeve Gastrectomy:
I'd never even heard of this one until last summer when my dad had it. When I started researching this one last year, I just KNEW that this was the one for me. It felt right to me...it didn't have the malabsorption problems that caused me to avoid gastric bypass, it just felt like the right one. You know how you just "know"?

So, last year I started the process that I would need to do to get my insurance to cover it. I had my dietician appt yesterday and all that's left now is getting the approval from the insurance (they're sending it to them now) and I have appts set up for upper GI, heart tests, etc for the end of September.

Yesterday, the dietician told me that because I'm diabetic, the surgeon would push for gastric bypass because it's the only proven "cure" for diabetes. I told her my concerns about malabsorption and she said that the surgery no longer causes that. WHAT?? I was shocked because I didn't think anything had changed in how they do the surgery, so how can it not cause malabsorption anymore?

So, now I'm torn! I would love the "cure" for diabetes, but am still worried about malabsorption after seeing all that my mom has gone through over the years.

Does anyone else know if something has changed in the gastric bypass to make it so there's not a significant vitamin deficiency problem? I know that I'll have to take vitamin supplements for the rest of my life regardless of which surgery I choose, but they told me there's no difference in the deficiencies between the sleeve or the bypass.

Since they had to know which surgery to send to the insurance company for approval, I went ahead and told them the bypass since they said we could change it later, but I still need to make a final decision in the next month or so.

Any advice will be greatly appreciated!!
Jen

 

[shelbell]

There are a number of different types of gastric bypass, so maybe they meant that your mum would have had an older type? Or it could be the distal/proximal difference? Can you call them for further clarification and ask what has actually changed?

Best of luck x

Sent from my iPhone using Forum Runner

 

[bigun]

im having a sleeve i have type 2 which i have been told will go once i have my op

 

[Very Big Chris]

I also chose the sleeve. My last hba1c was 6. The consultant tells me that I "may" be cured of my type 2 diabetes, but that only time and repeated testing will tell as it may be due to my change in diet.

I also chose the sleeve as I did not want the B12 injections for the rest of my life. Many US weightlifters and bodybuilders who have had the bypass claim that they "burn through" their B12 in 4 - 6 weeks and I lift and swim as part of my new lifestyle and could not face the prospect of all those jabs.

I had to argue my corner with the consultant, and he listened to my concerns and accepted my desire for a sleeve. He also told me that they can always go back and convert your sleeve to the full bypass should they feel you need it.

Remember, this is the era of informed consent. The more informed you are the better

Chris

 

[phatmomma]

I'm sorry to disappoint you but wls does not 'cure' your diabetes and you will always be diabetic.

You MAY not need meds for it though as it will be controlled by diet alone.

I was/am type 2 diabetic and stopped taking meds about 6 weeks post gastric bypass xx

 

[Big an Bouncy]

Not everyone will need b12 if they eat sensibly and take their vits.and its true what Julie says,if you are a diabetic pre op you will still be diabetic postop but not on the meds to control it, if you are lucky the change in diet will make a lot of difference.

 

[penguina]

I have always believe once a diabetic always a diabetic, but well controlled or diet controlled really. I was quite surprised when my surgeon used the word 'cure' to me.
Funny how even the 'experts' see it differently.

I still think I am diabetic, just diet controlled now.

I didn't have the option of the sleeve, but think bypass was better for me, with the malabsorption, as I tended to graze sometimes, as well as binge, large potions, I think I have every overeating disorder LOL (Changes that to had!)

Good luck with your quest, whichever way you go.

 

[jvan71]

Thank you all for the replies so far! My husband and I are going over to my parents house this evening to discuss this further.

I was also surprised to hear about bypass being a "cure". I'd never heard of this before either!

My current thoughts are to go with the sleeve since that's the one I feel the most comfortable with. If needed, I can always have it changed to a bypass later, but I can't go backwards from bypass to sleeve.

Once we discuss it all tonight, and if we decide the sleeve is still the right choice, I'm going to email the administrator for the surgeon to ask her to change my request to the sleeve before they send it to the insurance company. Luckily, we met late on Friday and she said they wouldn't send it until next week.

Thanks again for all the information!!
Jen