Controversial - Ghrelin is actually a GOOD thing!
DSer here. I'll be eight years post-op come December 11th.
I struggled with depression for YEARS. Took various anti-depressants, and they all worked---for a while. Are you familiar with something called "Prozac Poop-out"? Basically, it means that after a while the body adjusts to the anti-depressants and goes back to being depressed anyway.
Eventually, I just gave up on the meds. If anything, paying $100 a month for something that didn't work was just making me MORE depressed.
When I had my pre-op psych eval, I discussed all this with the psych. Volunteered to go back on the meds, if he thought I should. He felt that I knew myself and my depression issues well enough that I would know when ti ask for help post-op, should I need it.
I'm SO glad he felt this way---because about ten days post-op, my depression was G-O-N-E!!!! It was like flipping a switch---where there had been darkness, now there was light.
I don't know if it was the dramatic decrease in ghrelin or the bypassing of the duodenum, but SOMETHING radically changed my brain chemistry. At my two-mont check-up, I told my surgeon about this---and he told me that he'd had the same reports from several of his DS patients.
I KNOW that my experience is just that---mine. And I know that it's NOT the average experience. But I truly believe that something about my DS cured my depression.
Now---to YOUR situation. Your INSURANE company may not want to cover a DS for you, but the guidelines say that anyone who qualifies for WLS qualifies for a DS, and any qualified DS surgeon should do one on someone with a BMI greater than 40. I knwo one woman who got a DS with a BMI of 32, due to her severe diabetes. She's probably 10-11 years post-op now, and doing very well.
You can find a list of vetted DS surgeons, and a lot of good info about the DS, at www.dsfacts.com
I struggled with depression for YEARS. Took various anti-depressants, and they all worked---for a while. Are you familiar with something called "Prozac Poop-out"? Basically, it means that after a while the body adjusts to the anti-depressants and goes back to being depressed anyway.
Eventually, I just gave up on the meds. If anything, paying $100 a month for something that didn't work was just making me MORE depressed.
When I had my pre-op psych eval, I discussed all this with the psych. Volunteered to go back on the meds, if he thought I should. He felt that I knew myself and my depression issues well enough that I would know when ti ask for help post-op, should I need it.
I'm SO glad he felt this way---because about ten days post-op, my depression was G-O-N-E!!!! It was like flipping a switch---where there had been darkness, now there was light.
I don't know if it was the dramatic decrease in ghrelin or the bypassing of the duodenum, but SOMETHING radically changed my brain chemistry. At my two-mont check-up, I told my surgeon about this---and he told me that he'd had the same reports from several of his DS patients.
I KNOW that my experience is just that---mine. And I know that it's NOT the average experience. But I truly believe that something about my DS cured my depression.
Now---to YOUR situation. Your INSURANE company may not want to cover a DS for you, but the guidelines say that anyone who qualifies for WLS qualifies for a DS, and any qualified DS surgeon should do one on someone with a BMI greater than 40. I knwo one woman who got a DS with a BMI of 32, due to her severe diabetes. She's probably 10-11 years post-op now, and doing very well.
You can find a list of vetted DS surgeons, and a lot of good info about the DS, at www.dsfacts.com
Avonlea
on 10/2/11 3:14 am
on 10/2/11 3:14 am
If you want a malabsorptive surgery, I think you really need to consider traveling for the DS even if your local surgeon doesn't do it. Think twice, cut once, you know? I'm low 40s BMI too, and the DS is an option for me.
Mental function is hard to quantify. I saw a thread on the vertical sleeve talk board about people who felt "foggy" after the VSG, but it did seem to resolve, at least partially. I also wonder whether a looser sleeve, where more of the fundus is retained, will ease the impact.
Mental function is hard to quantify. I saw a thread on the vertical sleeve talk board about people who felt "foggy" after the VSG, but it did seem to resolve, at least partially. I also wonder whether a looser sleeve, where more of the fundus is retained, will ease the impact.
Brian I think its very wise to look at the whole picture including the down sides to WLS.
They certainly are out there so thank you for posting this information.
As for the risks I'd like to bring up the mal-absorption issues...I have heard some reports about older people who have had RNY and/or DS (when they were younger) and despite taking supplements are having problems absorbing protein and DYING. Also heard a pre-op person comment (maybe on this forum) that their primary care physician was glad they were getting a sleeve because his RNY and/or DS patients start "looking bad" 1 year out. Mal-absorption may not always be a good thing especially as we age and could very well could be equally concerning as the reduction of gherlin. I'm certain there are risks and changes in how our bodies function with any of the form of WLS but for me open heart surgery, hip and knee replacement surgery etc. etc. were far riskier. For me the VSG seemed to be the least risky WLS option in my desperation to actually lose a substantial amount of weight to improve my health and quality of life.
They certainly are out there so thank you for posting this information.
As for the risks I'd like to bring up the mal-absorption issues...I have heard some reports about older people who have had RNY and/or DS (when they were younger) and despite taking supplements are having problems absorbing protein and DYING. Also heard a pre-op person comment (maybe on this forum) that their primary care physician was glad they were getting a sleeve because his RNY and/or DS patients start "looking bad" 1 year out. Mal-absorption may not always be a good thing especially as we age and could very well could be equally concerning as the reduction of gherlin. I'm certain there are risks and changes in how our bodies function with any of the form of WLS but for me open heart surgery, hip and knee replacement surgery etc. etc. were far riskier. For me the VSG seemed to be the least risky WLS option in my desperation to actually lose a substantial amount of weight to improve my health and quality of life.
VSG Aug. 30, 2011 HW 266 SW 249 GW 166 lbs.
Avonlea
on 10/2/11 3:08 am
on 10/2/11 3:08 am
As a counterpoint, I have been investigating the DS for about four years now -- I am nothing if not deliberate about these things -- and I haven't found evidence of older patients dying who were compliant with their supplements. Believe me, I have been digging hard for those sorts of reports, and I'm just not finding them when I dig. As for the GP, frankly in my experience primary care physicians are almost universally ignorant of the details of bariatric surgery. They don't know much at all, and I don't weight their opinions very highly.
I say this because I don't think people should be scared away from the DS for anything other than documented reasons, not he said/she said anecdotal reports of what a doctor said here or there. I believe there are many people out there who will die unless they get the DS and they should consider this surgery carefully without being scared off.
That having been said, malabsorption is nothing to fool around with. I was going to get a DS but may get a VSG because I've uncovered both osteoperosis and iron malabsorption issues in my family, and I am not sure I'm willing to take the risk. I'm making that decision after about four years of investigation, and I'm still undecided, so it's not an easy decision for me.
I say this because I don't think people should be scared away from the DS for anything other than documented reasons, not he said/she said anecdotal reports of what a doctor said here or there. I believe there are many people out there who will die unless they get the DS and they should consider this surgery carefully without being scared off.
That having been said, malabsorption is nothing to fool around with. I was going to get a DS but may get a VSG because I've uncovered both osteoperosis and iron malabsorption issues in my family, and I am not sure I'm willing to take the risk. I'm making that decision after about four years of investigation, and I'm still undecided, so it's not an easy decision for me.
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