Really torn between VSG and DS

I am just beginning the WLS process and I've been reading these boards and a ton of literature about WLS.  I'm a lightweight at 227-lbs, BMI=38.5  I have several co-morbities and my insurance will pay for WLS.  I find myself going back and forth about DS and VSG. Now, the point may be moot if the surgeon decides the DS isn't going to be a good fit or if insurance refuses to pay for that particular surgery. But, still, here I am and I"m just having a "moment" I guess.

I like the VSG because I'm a little scared of the life-long malabsorption. But I'm worried that I won't be able to lose all the weight.  If the avg weight loss is only 55% of the excess weight, well that puts me at about 170 and that is just unacceptable. I've been 170 and I'm sorry, but that is still FAT. It is not worth it to me if I'm not going to be able to get down to at least 140--my personal goal is 125 (I'm 5'4").

But then I think, perhaps the DS would be better for me. I have mild type 2 diabetes, a1C=5.7, and insulin resistance.  I like the idea that i would be able to eat pretty much what I want, due to malabsorption. But what about those supplements? How much is that going to cost me? What if i can't get them all down? I And what happens when I'm an old lady? What if I get dementia and I can't remember to take my supplements or how to eat correctly?  I think with the malabsorption I could definitely get down to my goal weight, but at what cost?

I'm not really scared to have the surgery. I'm an RN, so I understand these things pretty well. I'm not afraid of the recovery--I've had surgeries before, so I know there's going to be pain and nausea and diarrhea.  I already drink a lot of water everyday.  I'm just ready to talk to the doctor and make the right decision and I dont' want to mess this up.

From what I understand, DS is usually only done for those with really high BMI unless you also have severe co-morbities along with a lower BMI.   It can also be done as a revision if the original surgery doesn't get the desired results even though you've been following the program.   It may be up to your surgeons recommondation or what your insurance will cover.....the DS being more expensive.  I don't know what self pay docs do.....

From what I understand, DS is usually only done for those with really high BMI unless you also have severe co-morbities along with a lower BMI.

NOT TRUE....my BMI was 35.2 (I BARELY qualified for WLS at all) and I was able to have the DS due to needing the malabsorptive component AND the need to take NSAIDS.

Also MANY insurance companies are limiting surgeries to one per lifetime regardless of who paid for the original. So think TWICE, cut once...do not plan to revise at a later date IF you do not get the results you want.

Oh, and the self pay price for my doctor was the same for the DS as it was for the RNY at the time I had my surgery (thankfully I had Medicare to pay for mine anyway)

Liz

Hi there,

You sound like you need to follow up with the surgeon and your insurance company to see what is done and covered.  That may decide which one you have.

Your fears are normal normal normal.  I think most pre-op patients have those same questions.  One thing that I usually tell folks is that surgery is only step one. It is not an means to an end.  There are other steps that need to be set up before surgery and have in place for after.  As an RN, you know the head games we go through.  This is the battle ground.  Also, you know how important it is to learn to make healthy choices, exercise portion control, develop a healthy relationship with food and exchange bad habits for good.  Like most of us, we can't do it alone. We don't have the tools we need to overcome the challenges associated with obesity.  Find an activity you enjoy to gain lean muscles and strong body.

So, whichever procedure you decide on, it is important to have all your ducks in a row so you can set yourself up for success by setting up your support systems now.

Check out DSFacts and come visit us on the Lightweight group...many of us have had the DS.

Liz

I'd like to meet some REALLY  OLD DS ers ifthere really ARE  any out there ... 

A year or so ago Dr. Hess' very first DSer was still going strong. Bound to be in his 80's by now.

Please keep doing your research and reading these boards.  There's absolutely no reason you can't lose 100'% of your excess weight with VSG.   I'm a lightweight too and started out at 235 lbs. with a surgery weight of 218.  Less than 3 months out and I've already lost 50% of my excess body weight.  And I'm on track to be in the healthy BMI range by the end of the year. 

I'm not super-woman or doing anything different from all the other people on this forum.  I exercise very moderately, eat 80+ grams of protein per day, 40 grams or less of carb per day and drink 80-100 oz. of water per day.  The only supplements I take are a multi-vitamin, calcium with D and iron (because I've always been anemic).   This is less than what I was taking BEFORE surgery. 

Hello,

Here is a link of posts where members are discussing the same subject.  Review both pros and cons and ask yourself which on you can live with for the rest of your life.  Also, make sure you research and have a detailed understanding of both procedures.

Vertical Banded Gastroplasty

Duodenal Switch

http://www.obesityhelp.com/search/action,search_oh/?q=VSG+vs +DS&cx=000946886326336472648%3Ae-vpeg4uyxw&cof=FORID%3A9

No form of WLS is going to guarantee you'll lose 100% of your excess weight. The DS has the best long-term stats, of around 80% at ten years post-op. It's also got the best stats for resolving diabetes. That alone was a very good reason to choose it in my opinion.

Your supplements would depend entirely on YOUR labs, and how careful a shopper you are. As for what happens when you're an old lady---well, I've always said that if I develop dementia to the point of not being able to take care of myself, then it's past time for me to die.

It's all a matter of how you want to live the rest of your life. My previous experience with life-long dieting told me I'd probably be a lot happier taking a handful of vites 4 times a day than spending all day, every day, resisting the temptation of good food. Nearly ten years later my labs are pretty good and I'm eating pretty much anything I choose, so---I think I made the right decision.