Choosing RNY over VSG

So today I went toy pre-op appointments. Please forgive the wall of text to follow...

We talked about my reasonings to go with VSG verses RNY, and why I chose VSG.  I told him that I was a little scared about getting my intestines rearranged.  We talked about my diabetes.  He said that with VSG I might not get off my insulin, but with RNY I might be off my insulin by the time I leave the hospital.  I was shocked.  Get off my insulin?  That would be a huge plus!  Then we talked about weight loss.  He said with VSG I'm only looking at losing around 100 pounds.  I don't want to go through this to be 300 pounds.  That's not what I'm interested in at all.  He said not only would I lose more with RNY but with my acid reflux and diabetes I'd probably end up getting RNY eventually anyway. 

So I made the decision right there and then.  We'd be trying to go for RNY surgery instead of VSG.  Now he said that he might get in there and only be able to do VSG, he won't know until he gets in there.  But if he can do the RNY at that moment, that's what we're going to do.

I know it's a shock.  I know it basically renders my blog title useless.  But this is my journey and I want it to be the best it possibly can be.  I want to lose the weight, I want to be healthier.  I want to get to ONEderland.  I need this to work.  I need to put in the work and be secure that my surgery is working with me, not against me.  And I fear that VSG might work against me in the long run. 

So I chose to have RNY. And I think that's what is going to work best for me.

Have you considered the DS?  At your weight and as a diabetic on insulin you are a perfect candidate.  

It is highly possible that you won't go into remission with RNY - it really depends on how long you have been diabetic and how much insulin etc you take.   It is also highly possible that if you go into remission,  that you will find yourself back on insulin in the future.   With the DS, it is 90+% likely that type II diabetes goes into permanent remission (no such thing as a cure for diabetes)

I think it is unlikely that your surgeon is able to do this surgery (or I am sure he would have offered it) so consider finding one - it is way easier to do a virgin DS than ending up with a revision later.

I've only been on insulin for about 6 months. No he doesn't do the DS and I don't think there's anyone in the area who does. But the DS is a little scary for me... I think I'm going to stick with RNY for now, but thank you!

I think that you made the best decision for yourself and your health and it is wonderful you listened to him!  It is YOUR journey and it needs to be what you want it to be and definitely with the reflux and diabetes it sounds like you are on the right track!  How exciting!  If you are unable to go the DS route, it sounds like this outcome will end up being much better long term for you.  When I made the decision a part of my own thoughts were why would I want to have surgery just to possibly have to turn around and have another one if I can go through it once and take care of most of the issues....that is what I think happened in your mind as well?  Either way....whichever you choose....I wish you the best and the first steps are taken!!!

I'm sorry that he gave you false information about the amount of weight lost with VSG vs RNY. Multiple studies have shown that while RNY might lose more initially, long term loss statistics are pretty much exactly the same. 

If you have only been on insulin for six months, there is a good chance you will be off of it.  People who have been on insulin for ten years of more are less likely to get off of it

I have nothing negative to say about a VSG as I didn't have one -- but I do know that some people can and do lose a ton of weight after one and that they are a good and arguable best option for some.  I can tell you from personal experience that I was on insulin (Novolog pen) 3x per day and Metformin 1000 mg 2x per day for diabetes.  I had been diagnosed for 8 years and on insulin for the last two.  My a1C averaged between 6.5 and 8.  I had also recently acquired mild HBP and was on medication for that and to protect my kidneys which spilled protein.  ANYHOW, after my RNY I was off insulin within a week of surgery.  I no longer take any medication other than my vitamin supplements.  My diabetes is in complete remission with an a1C of 4.2.  I eat a very low carb diet because I want to do as much as possible to prevent it from coming back or at least establish the healthiest eating habit if (god forbid) it does. 

I wish you the same success.  

The surgeon told me RNY for the same reasons.  My BMI was in the 60's and now in the 30's. My weight has been shy of onderland for a few months but it's keeps me vigilant to get there someday, somehow, someway.  

If you read the boards here there are many people with VSG and 100+ lb. weight losses. That being said with the Diabetes and GERD you are probably better off with RNY.