Initial One-on-One with the Doctor

So, today, I met with my doctor and we had a major change come up. He indicated that due to my age, he did not know if Roux-En-Y would be the best choice for me because of how drastic it changes your digestive track, as well as the fact that you have to be on a strict vitamin regimen for the rest of your life. He suggested I have the Gastric Sleeve done, and after having explained the differences to me, he sold me. It will take more self-regulation of not eating sweets or other high calorie food, but overall, I think it's going to be a far better choice for me. It involves the Restriction without the Malabsorption. The valve and small intestine are completely kept in tact, and there is a far shorter recovery time.

They had me meet briefly with the insurance consultant who gave all the orders for the supplemental testing and meeting I needed to have to qualify. I scheduled appointments to meet with the nutritionist, psychologist, and get my blood work, EKG and ultrasound completed. These are all standard and need to be done by all candidates for the surgery. They check to make sure you're of healthy mind and body before going into bariatric. So, I have several appointments over the next week and a half or so, but I'm excited to get the ball rolling!

Here is a great side-by-side comparison I got from http://www.gastricsleeve.us/gastric-sleeve-vs-gastric-bypass.html about the difference between the Sleeve and the RNY. You have to choose what's best for you after discussing with your own doctor.

Weight Loss Procedure	Gastric Sleeve	Roux-en-Y Gastric Bypass
Approach to Weight Loss	Restriction Limits food ingestion Controls hunger sensations	Restriction & Malabsorption     Limits food ingestion Reduces food absorption
Changes to Stomach	Stomach size reduced 75-80% of the stomach is cut away along the greater curvature and removed from the body	Stomach size reduced and new stomach outlet (stoma) created     Stomach is separated into two and stoma is created in the smaller upper pouch; lower remaining portion of the stomach is bypassed
Changes to Small Intestine	Kept intact	Cut and rerouted     Small intestine is cut in the middle; upper section is bypassed and lower section is attached to the stoma
Changes to Pyloric Valve	Kept intact	Bypassed
Average Operating Time	1 to 3 hours	2 hours
Average Hospital Stay	2 to 3 days	2 to 3 days
Average Time off Work	2 weeks	2 to 3 weeks
Average Recovery Time	3 weeks	3 months
Causes Dumping Syndrome	No	Yes
Dietary Guidelines	600-800 calories per day, during weight loss period 1000-1200 calories per day for weight maintenance Meals should consist of high-protein, low-carbohydrate and low-fat foods Drink 6-8 cups of water or other low-calorie liquids per day	800 calories per day during weight loss period 1000-1200 calories per day for weight maintenance Meals should focus on protein-rich foods and nutrient-rich fruits and vegetables Drink 6-8 cups of water or other low-calorie liquids per day Chew foods thoroughly into a pureed consistency
Eating Habits	Eat five small healthy meals each day Do not eat and drink at same time Do not overeat, skip meals, or snack between meals	Eat three small protein-rich meals each day Do not eat and drink at same time Chew foods into a pureed consistency Do not overeat, skip meals, or snack between meals
Problematic foods	Not many problematic food as the stomach continues to function normally, but high-calorie and high-fat foods and drinks must be avoided and daily calories limited for weight loss to occur	Foods that are dry, sticky, or fibrous can cause discomfort or blockage, including tough meat, bread, pasta, rice, raw vegetables, nuts, popcorn, and skins of fruits and vegetables, and chewing gum Sweets can cause Dumping syndrome Carbonated beverages can cause bloating High-calorie, high-sugar, high-fat foods and beverages will ruin weight loss efforts
Nutritional Supplements	Multivitamin Calcium Vitamin B12	Multivitamin Calcium Vitamin B12 Iron
Average Weight Loss	Studies show greater than 60% excess weight loss at 12 months after surgery and a maintained excess weight loss of 53-69% at 5 year follow-up.(1)	Rapid weight loss during first 6 months Weight loss settles 18 to 24 months after surgery 70% excess weight loss at 1 year 60% excess weight loss at 5 years

REFERENCES

1. ASMBS Clinical Issues Committee, "Updated Position Statement on Sleeve Gastrectomy as a Bariatric Procedure," Surg Obes Relat Dis. 2012 May-Jun;8(3):e21-6. doi: 10.1016/j.soard.2012.02.001. Epub 2012 Feb 10.
2. Bethany J. Slater, Nina Bellatorre, and Dan Eisenberg, "Early Postoperative Outcomes and Medication Cost Savings after Laparoscopic Sleeve Gastrectomy in Morbidly Obese Patients with Type 2 Diabetes," Journal of Obesity, vol. 2011, Article ID 350523, 5 pages, 2011. doi:10.1155/2011/350523.