Information, please

 I will be seeing my PCP on Wednesday and I am quite certain she will approve my choice to have WLS.  I have tried unsuccessfully to lose weight and due to back surgery and other health issues including an aortic aneurysm, my excessive weight poses serious problems currently and they are sure to increase in the future.  I have been reluctant to consider WLS prior to now but I have been reading about the sleeve gastroectomy or VSG and feel this may be just what I need.  I would like to hear first-hand from patients what to expect:  how long before the actual surgery, what prerequisites, out-of-pocket expenses (I have Blue Cross Blue Shield standard option), how much post-op pain and recovery, how rapid weight loss will commence and average weight loss per month...in general, any information that can be provided would be most appreciated.
I have been diagnosed as pre-diabetic.  Has anybody found a reversal in this trend after WLS and the same with high blood pressure?  I must keep my blood pressure down due to the aneurysm and want to postpone that surgery as long as possible.  There is no laproscopic repair for that and I'm in no hurry to have my chest cracked open.  Yet another reason to get my weight to a normal, average area.  Thank you in advance for any and all information you can provide.  

Jacksonsgrandma

Hi and welcome. Have you thoroughly researched all of your surgery options, including the duodenal switch? It's the procedure with the very best results for metabolic issues and type II diabetes. Learn more about it at www.dsfacts.com .

I believe that there are only two decent WLS options, the VSG for restriction only and the DS for restriction plus malabsorption and metabolic changes. So I congratulate you on finding the VSG as an option!

Weight loss almost always improves blood sugar issues and blood pressure. It's not 100% all the time, but it's sure a biggie. The big thing is, of course, not so much getting the weight off as *keeping* it off. Surgical options are getting better at helping us to do that. There is definitely hope.

 I love the sleeve, but agree with EN above about looking at all options, particularly the DS. 

I was insulin resistant, and was pre-diabetic. The DS has the best cure rates for for type 2 diabetes, and yes, I said cure. Any weight loss can help resolve t2D, but there is extra metabolic help with the DS, that keeps it from returning if weight were regained. You can get remission with the other surgeries of the t2D, but if you regain the weight, the blood sugar issues return. The DS has the best rates for just about everything, but you need to do your own research, and a great place to find the most current medical studies and other information is at DSfacts.com.

My blood pressure now runs low, which I've seen people mention with any type weight loss. Low isn't necessarily good, but in your case, would be.

The pre-requisites are usually the same for any of the surgeries, unless you go outside the US, which I doubt your doing since you have insurance. The recovery varies quite a bit from person to person, but it's not usually a walk in the park. I thought a few weeks of feeling like road kill was worth getting the rest of my life back. 

Have you had luck loosing weight and maintaining that weight loss by restricting your calories?  Because that is what the sleeve does.  And we know that over time the sleeves stretch which allows you to eat more.

We say that the Sleeve is what helps us loose weight but the switch is what helps us maintain our weight.  I know that has been very true for me.

For anyone with metabolic issues the DS should be seriously considered since it has such a huge metabolic effect that is maintained over time. 

The DS has the best stats for everything that is studied in regards to WLS except for the resolution of GERD.  Most weight lost, best maintainence, best CURE for T2D, etc.....

Both my normal weight parents died from t2d at relatively young ages which was my main motivator for getting the DS.   The other positives about the DS, including what you can eat, have been gravy.

~Becky

 Hi Jacksonsgrandma,

Everyone is different when they lose weight, we can only share our experiences.  After I lost all my weight and hit goal I did not have to take anymore meds.  I was taking meds for High Blood Pressure, Gout, Acid Reflex, Diabetes, and Lexapro.  I can't tell you what a difference you feel when the weight comes off and more importantly you keep it off.

Good luck to you!

Take care,
Kathy

I so appreciate the responses.  I have not researched the DS but it appears I should do so before I speak to my physician.  My goal is to KEEP the weight off - I've gained and lost tons over the years and am tired of yoyo dieting.  At this stage of my life (I'm 57) I don't think it helps my health at all.  I think this is a great site for support.  Much more than the employees at Medical Weight Loss Center.  I think they were all born underweight and would rather die than be caught in anything larger than a size 7.  Hard fo identify with, if you know what I mean.

I look forward to talking and hearing from you all again soon. Thanks so much for your input.  I better get cracking reading up on DS.

Jacksonsgrandma

You may want to go over to the VSG board if you want more responses about VSG in particular.

My experience - I'd always been able to lose weight, just not keep it off.  And I was hungry ALL THE TIME.  I felt that the malabsorptive procedures (RNY and DS) were too invasive and too drastic for what I needed.  I didn't want to deal with the vitamin deficiencies.

I had the sleeve 7 months ago.  I'm happy with my weight loss, but I hate to give you numbers because everyone loses at a different rate.  I WILL tell you that you will lose slower with the sleeve than the RNY or DS because we don't have the malabsorption.  My weight loss has been nice and steady and stress free.

By removing the large stretchy part of your stomach, you lose a lot of the hunger hormone ghrelin.  My hunger is now what I consider to be normal.  I feel hungry after 3-4 hours, and small meals (about 4 oz) satisfy me.  And, not to cause an argument, but the sleeve doesn't stretch.  They make the VSG sleeve smaller and tighter that the DS sleeve.  The stretchy part is gone.  The swelling from surgery will go down, and the stomach will actually grow a little bit over time, but it will never get back to what it was or anything close.  According to my doc, you'd have to purposely overeat to the point of vomiting over and over and over and over and over (you get the idea!) to "stretch" your sleeve - and then it would be damaged, not truly stretched.

I was diabetic and hypertensive pre-op.  Haven't taken anything for diabetes since the day before surgery and my current A1C is 4.7.  Got off the blood pressure meds 2 months after surgery.  VSGers take vitamins - multi, calcium, B12 and maybe iron. 

Are you BCBS-FEP Standard?  If so, you pay 10% of the charges.  Mine came to $2,500, but it's going to vary depending on what your hospital charges.  Doc's charges seem to be comparable, but the costs of the hospitals vary wildly!

 I don't really agree with some of the info your surgeon has given you, and you may get more accurate advice researching elsewhere. The surgeons I talked to, all made the VSG that same size as the DS sleeve. There are some exceptions, but most now make them the same. My stomach was made 3oz, the same as his stand alone sleeves. Both the sleeve and DS stomach used to be made much larger by some surgeons.

I also don't agree about the stomach not stretching. It does, just not back to pre-surgery volume. That's not really possible without the fundis, but you don't have to abuse your stomach/sleeve to have it stretch some.

It wasn't my doc that told me about the differnt sized sleeves.  It was a couple of DSers.  And they could have been mistaken.

On the stretching, we're probably just arguing about terms.  My doc said it would "mature" (that was his actual word), so, yes, your capacity increases - to around 12 oz, give or take.  Significantly less  that I could put away pre-op.  The only issue I have with folks talking about the sleeve stretching is that it sounds like you're right back where you started with a pre-op stomach, and that's nowhere near true.

 Yah, I agree it's more like terms, as I'm not arguing with you. I love the sleeve, and agree that people need to understand that once the stomach is sleeved, whether with the DS or VSG, it will never stretch back to it's previous capacity. 

My sleeve was made 3oz, and at 3 1/2 years out, I've maybe doubled in capacity (not sure, I don't really stuff myself to check that) but thank goodness, cuz it's hard to eat enough when you can still only eat 2 bites per meal.