Good Morning. TGIF, babeees!

Well, it's been a week...

Ok, ok. Thought for the day.  No matter what decision you make about something important...like WLS, there's no free lunch. There will always be pros and cons to each choice. Choose wisely. {in the voice of the old knight in Indiana Jones and the Last Crusade}

Question. Were you told of the pros and cons to each WLS type discussed with you? What made you choose the WLS you chose? Now, lets see if we can discuss this without starting a surgery war or a my-surgeon-is-better-than-your-surgeon war.

Y'all have a great Friday!

--gina
 

Good Morning, Gina!

TGIF......

Initially I chose a surgeon based on his reputation and results, program,Center of excellance etc.  Loved everything about them including the office staff.  Turns out, my Ins would not cover them and because I could not go into debt for this (Not fair to the family) I had to move on to another Doctor that was covered :-(   When I did I still loved my surgeon but the office staff was so-so.  At each office I was only given a choice of lap band or RNY as that is all that my Insurance would cover.  I was dead set on lap band.... in the beginning. 

After hearing the pros and cons and finally getting my husbands blessing, I chose RNY.  I did not think I would be successful with the Lap band long term and the stories of those that had the lap band long term were scary. 

I love my RNY wish I had other options, but I had to go with what was covered.  If given the option I would have chosen DS. At each visit and I only had 3 and especially the initial visit they went over the pros and cons and to be honest seemed to be against the lapband. I wanted success! I figured this wasd my last opportunity to get this right. I mean afte surgery what else is there? In the end  I am happy with my results no way I could have lost 105 lbs on my own.  While I do find it harder the further I get out, it is still a tool that works for me. 

My surgeons office, I could take or leave.  i loved the surgeon, and nut, but the Nut left shortly after I started my program and I have not gotten much advice along the way from the bariatric coordinator turned nut.  That is my only complaint. I feel I would have done better with more food guidance. 

Overall no complaints about my surgery, I know my limitations, love my new body and of course all of you!

Have a great long weekend everyone.

Sheri

Good question.  I THOUGHT I had done my research and chosen wisely but was ultimately swayed by  my first surgeon to go with one kind of surgery.  Four years later, and a complete failure, I realized that I had been given false info (for example I was told I was not a candidate for RNY because of my blood clot history) and that this surgeon always pushed the surgery I ultimately chose (convenience, cost, ease of surgery,, glory--I have no idea)

My therapist ultimately recommended that I see Dr. Rosenthal.  I didn't know about anything other than RNY and lapband at that point.  Dr. R was completely honest, explained all my choices and had his staff confirm which choices were covered by my insurance.  He also explained the difference between surgery with malabsorption factors and those which are just restrictive in nature.

Said blood clots were not an issue but had me see a hematologist for consult anyway.

Long story short--revision to RNY changed my life and was the right decision for me.

NO ONE SHOULD MAKE THEIR CHOICE BASED ON ANYONE ELSE'S CHOICES!!
Janet

well my main issue was that I was underweight to qualify properly ... so I was ecstatic to be offered any surgery at all .

I REALLY knew I needed a DS being a hard- core lifelong food addict even then but i figured asking for it was just going to have my sanity questioned ... so I went with the suggested proximal RNY .

Actually Im happy with the results two years out ... but i wish i had both more restriction and more malabsorption . And I know as I age I will probably have to revise to a DS .

I really wish id asked for the sleeve . That at least would be and EASIER revision ... but the RNY really DID resolve my acid reflux issues beautifully .

As faras lapband goes i went to a seminar where the surgeon had a lapband and he talked about eating only one meal a day to keep his weight stable and limiting his intake to 800-900 calories or gaining .

I said ... feet don't fail me now ... THAT Surgery Is NOT FOR ME LOL !!

I did kind of misunderstand the sleeve as more similar to lapband than it is ...( i now think i could have lost my weight with it as easily as i did withthe RNY ) and OVER estimated the RNYs malabsorptive component ( which everyone fails to mention lasts only 18 months grr...) Had I known these two things I would have probably gone for the sleeve .

With this group, I do not believe that we will ever have a "my surgery is better than yours" war. We all seem to be accepting of everyone elses decisions and very supportive. I personally like hearing about the other surgeries and how they have affected them or how it has done horrible.


As far as being told pros and cons of surgeries, nope. That was something I had to find out on my own. We had a small 4 hour briefing, they say presentation, where the NUT, psyche an intern and the Drs personal assistant came in and told us what our options were. RNY or Lap band, then she took our BMI and told us we could not gain an OUNCE from this miment on!

With military you have to have a BMI of 35 or higher to qualify, 5 yr history and 1 comorbidity. I had several... Ok Long story short, I went in with the idea that I could only have a lap band because I was a lightweight but I really did not want it. I know my triggers, I know what causes me to gain but most of all, I had already been doing research for 3 years prior to getting surgery. I was already doing the adkins diet and had lost 30 pounds. I went from a 220 to 190, and that is where I stayed, Started excercising, cut all sweets, carbs..You name it I did it, I did it for a full year and I gained 15 back. No clue to this day what I did wrong because I am still eating the way I did prior to surgery (anyone with insight please let me know)
I knew Lap band would not give me the restriction I would need or even wanted to fulfill my goal,I had other issues that I wanted cleared up faster than a lap band would allow also.

Now that I look upon it, I made the best decision ever, for what was given to me.

My first goal was to find the right surgeon.  I got a recommendation from a friend who was actively involved in the WLS industry. 

My surgeon gave the pros and cons of four surgeries.  I have to say that he really didn't cover too many pros about the DS.  He refuses to do the DS procedure because in his mind there is just too much risk with the complications. 

I knew the lap-band wasn't for me.  Too much maintenance, not a great track record of success.  It boiled down to the sleeve or the RNY.  I wanted the malabsorption component. So I went with RNY.  So far, it has been the right choice for me. 

But...I would have given the DS stronger consideration knowing what I know now.  It would have been a tough choice since my surgeon and his practice are the best in my area.

Kay

I went to a seminar here in Michigan and had an awful time with the staff of the Dr's office, so I ended up calling a friend who had the surgery in VA.  She gave me the phone number and I called them.  This office has been awesome and did nothing short of bending over backwards to help me through the process.

I didn't do my homework except go to the seminar here.  There was a husband/wife team who had the Lap Band that they had speak - really?  They were NOT the type of people I would have had speak, as they said they cheated, didn't do what they were always supposed to do, etc.  Their weight loss of 40 lbs in a year didn't impress me. 

They covered VSG but not much.  Said it was "still in its infancy" and the DS wasn't offered by them and they just said there wasn't much known about it (which now I know is a bunch of crock).

So - I went with the RNY because that's what I thought I should have.  I loved my RNY except for the RH that I have developed.  I know how to control it and what triggers it, so that helps keep me away from simple carbs - so there's always a good side!! LOL

We were not told about the different surgeries and what types of people would benefit from each, like you list.  That would have been good to know before hand.

Hi all,

There was only one surgeon in my area that did WL surg. that had a good reputation, and my options were lap band or RNY.  The RNY ssemd to be recommended and I was told it was the "gold standard".  I really had not heard about the other surgeries.  I went to the seminars and support group and knew I wanted restriction, malabsorption, better track record, and resolution of my GERD.  At just over a yr out I am happy with the results (100 lb wt loss). Maintence has not been hard YET.  I get a little worried about it long term because I have had to increase my carbs to keep my wt. up....bad habits I'm afraid long term.  I may  have to deal with that at a later point.

Jane

I did a lot of research on my own.  My center of excellence basically only recommended RNY but I chose a surgeon who also did VSG's.  I pleaded my case and won.  I wasn't comfortable with fills and unfills and band maintenance or malabsorption long term.  I couldn't be happier with my VSG and am really glad that I advocated for myself.  Whatever you choose, you have to be comfortable with it and not just accept whatever you can get, when possible.

 OK, not starting a war, just my personal experience.
I started thinking about WLS in 2000 but my insurance didn't cover it.  In 2001 I got on Social Security and Medicare but I didn't know if WLS was covered.  In 2002 I saw my PCP and asked her if she thought I would qualify and she referred me to a surgeon at the university hospital her..  I saw her in May and my appointment was in August.  In June my sister had a RNY.  I had my appointment with the surgeon in August and was giving a handout that listed the surgery they did there, the lap band, the RNY and the DS and a little about each one.  I never considered the lap band even though I knew nothing about it then.  I was leaning towards the RNY since my sister had it and was doing well.  I remember reading about the DS and it said something about the side effects being extremely smelly gas and diarrhea and I figured that wasn't for me.  The surgeon recommended the RNY and I agreed.  I was given a surgery date at that time.  No other appointments, no seminars, no visit with a NUT, just an appointment.  I don't even think I had to have any testing done other then blood work.  I was already having a cardiac work up being done by my PCP because of issues I was having but it wasn't required for my surgery.
I decided to go to a support group totally  on my own.  It was not required.  At the support group there were several people who had the DS.  They were mostly under one year post op.  They talked about how wonderful life was and how they could eat anything and not worry about dumping.  Before the support group many of us would meet for dinner and I could see them eating all kinds of things like bread and dessert.  Most of them had lost a great deal of weight and talked about how effortless it was.  I became friends with one woman *****ally talked up the surgery and told me I should consider it.  I was never pushed at all but seeing how these people could eat and hearing about how people ate after the RNY made me want a DS, too.  Three weeks before my surgery date I contacted my surgeon and asked to have my surgery changed to a DS.
I had my surgery in October, 2002.  I was given no post op diet instructions beyond the  first few weeks of eating soft food.  I was instructed to take a multivitamin a day and about 1500 mg of calcium citrate.  I think I had read on line about needing to take ADEKs because they were fat soluble and were malabsorbed.  At that time I remember purchasing them on line and taking 3 or 4 a day of the chew ables, very big pills.  I was also told about  having to have my labs run several times the first year and then yearly after that.
I attended support groups monthly and participated in an on line support group and that is where I got all my information.  There was very little dietary advice other then getting  in at least 100 grams of protein a day and to eat low carb.  I knew that simple carbs were absorbed 100%.  I don't remember hearing that white carbs contributed to gas and diarrhea problems.  Most of the people I knew with the DS had those problems.  In fact, I can honestly say that I don't remember hearing about one person having a problem with constipation.  I figured it was normal.
I had a lot of problems with diarrhea.  I had several stool cultures and was on Flagyl several times until my doctor refused to prescribe it anymore.  I also got very sick because of an overgrowth of bacteria in my intestines.  To make a long story short, it caused toxins to be released and an autoimmune response that caused me to have reactive arthritis and rashes.  I was very sick for at least a month.  It was treated with antibiotics and I eventually got better, although I continued to struggle with gas and diarrhea.
During the first 2 years I lost weight in spite of what I ate so I figured I could live with the side effects.  I felt it was a small price to pay for weight loss.  I never felt much restriction.  I found out that my surgeon only removed 50% of the stomach, which wasn't a lot.  I hear that now, with the VSG they remove up to 85% of the stomach.  I ate whatever I wanted with no changes and didn't realize that the white carbs were contributing to my intestinal problems.
After 2  years I started regaining but I figured it was the expected bounce back weight.  By year 3 I had gained about 10 to 15 pounds.  The intestinal problems continued to get worse.
By year 4 I had gained about another 10 to 15 lbs.  I still wasn't worried because I was at an acceptable weight and I felt that it was worth being heavier if I could eat the way I was eating.
I really thought that my weight was going to stabilize as it seemed to with other people who had the DS.  I had also stopped going to the support group and didn't participate on line too much.
It was about year 6 that things felt like they were getting out of control.  I felt like I could eat as much as I did before the surgery and the weight was coming on pretty quickly.  I was going to the bathroom many times a day and it was interfering with my life.  I also was having several accidents, which was extremely embarrassing.  I knew that I was out of control with the sugar and bread and decided to stop eating them.  I also started going to OA to deal with my eating issues.
I lost weight, slowly, but I managed to lose about 30 or so pounds and got to a comfortable weight but I was fighting hunger all the time.  I was still having the bathroom issues.  I would frequently be woken up to use the bathroom, sometimes many times a night.  I was still having accidents and thought about wearing adult diapers.
Around this time I started suffering from severe fatigue.  I got to where I could hardly leave the house.  I started eating refined carbs again and regaining weight. 
I had also cut back on the vitamins I was taking.  I still took the multivitamins but I didn't take all the calcium I was supposed to and I stopped taking the ADEKs.  I thought that since I could eat so much food and I was gaining weight I must be getting in enough vitamins.
I was seeing a doctor about the fatigue.  I had all kinds of tests run, sleep studies, pulmonary function tests, thyroid tests, and nothing was found.
I had been having my labs done by my surgeon yearly as I was told and I was told that my levels were fine.
I finally started to think that maybe my fatigue may be related to my WLS.  I called the friend that I had who had the DS and talked to her about my health problems.  She directed me to the list of labs that I needed done.  I had never had a complete set of labs run, even by my surgeon.  
The labs showed that I had very low D and low ferritin.  I increased my D (I had started back on my supplements) and had an iron infusion.  I was hoping that would help me feel better. I didn't realize at the time that many of the labs I had requested weren't done for some reason.
I still felt like crap and it was getting worse.  I had to stop watching my granddaughter because I couldn't keep up with her.  I couldn't do anything.  I had no life.  I finally got to the point where I regretted having WLS.  I had regained most of the weight I lost and I was sick all the time.  I made an appointment with my surgeon to ask him to reverse my surgery.  I didn't even care about gaining weight at that time.  I just wanted my health back.
I called the surgeon's office and for some reason I got an appointment right away.  That surprised me because every time I had to make an appointment before I had to wait a long time but I told them I was having problems and they got me right in.
When I went to my appointment I found out that my surgeon didn't do the DS anymore and that the hospital stopped doing it, too.  I was told that they had too many problems with people having long term complications.  In hindsight I can see why with such terrible education and follow up.  I was also told that the surgery couldn't be reversed, only revised so I wouldn't malabsorb so much.
My surgeon agreed to revise me and also offered to give me a RNY pouch.  I hadn't even thought about having another WLS.  I just wanted to feel better.  I didn't go because of the weight gain and that wasn't my priority at that time but I realized that if I had managed to regain 100lbs with malabsorption that without it I was really going to pack on the pounds so I agreed to the pouch.  I really didn't give it any thought at all, I just instinctively agreed.  All I could think of is that I had a DS and regained most of my weight and my sister had a RNY and kept most of her weight off.
The surgery was scheduled for 8 days later because they considered it somewhat of an emergency because of my health.  I never had any time to really think about it.  All I could think about was that I was finally going to get better.  I didn't do any research or even think about seeing another surgeon to keep my DS.  In my mind I just wanted to end the malabsorption.
The surgery was done open and went pretty well.  I had no real complications.  Of course I was put on the post op diet, clear liquids and then full liquids, and so on.  This time I did see a dietitian and was given a post op diet plan, which I stuck with 100%.  I decided that I needed to completely stay away from refined carbs.
I went through a period of remorse and wishing I had never had the pouch done but I never regretted having my intestines lengthened.  I went almost immediately from having constant diarrhea to having constipation.  The gas was gone and I felt better right away.
After a few weeks I started reading at OH again.  I hadn't been on it for a long time.  I posted about my revision and was immediately flamed by the radical DSers who could not believe that someone was stupid enough to have a DS revised to a RNY.  I was told that my surgeon was a butcher.  I was the subject of threads about my lack of intelligence.  Obviously I didn't find the support I was looking for.  It was during this time that I got a PM about the lightweight group and I decided to check it out.  It was here that I found the support I needed.
I was at my lowest point after my revision.  I still felt very weak and doubting my decision and then to feel attacked along with that really hurt me.
I finally was able to have a complete set of labs done at about 6 months out.  At that point I had been taking vitamins for a while and my labs were pretty good.  There were a few things that were at the lower end of normal that I added into my routine.  I also started seeing another PCP and saw a doctor about my severe depression and was given new medication for that.
It has been a slow road to recovery for me.  Compared to how I felt pre op I feel like a new person.  I am still not running laps but I am functioning.  I have lost all the excess weight and I am eating healthy for the first time in years.  
I found out at about 6 months post op that most of my stomach, along with my pyloric valve was removed.  I wasn't happy about that but there wasn't much I could do about it at that point.  The one good thing about that is that I believe that I believe that I am not producing grehelin so I don't have any hunger.  I have been able to stick with a healthy plan because of that.
I am an anomaly because I still have a DS intestinal configuration with a 200cc common channel.  I don't know how much malabsorption I have but I take my supplements like I have a lot.  I will get my labs done again at 1 year and adjust my vitamins accordingly.  I plan on having my labs run every 6 months for a while to see how they go.  I plan on staying on top of things so that I never have to go through what I went through again.
In hindsight I realize I would have done better with a longer common channel and a smaller sleeve.  If I had it to do all over again I would have seen another surgeon to see if I could have had that done.  But I did the best I could with what I had at the time and I don't regret anything now.  Regrets don't get you anywhere so I hopefully just learn from my mistakes and move on.  Fortunately I don't have any issues with my stomach.  I can eat pretty much anything that I have tried.  I do dump but I don't really consider that a bad thing since I am a refined carb addict and it give me one more reason to avoid sugar.  I do worry about reactive hypoglycemia but so far I haven't had any symptoms of it.  It just gives me one more reason to avoid the refined carbs.
Sorry this has been so long and bless you if you have read through all this.  It is just a long story to try to explain.