Denial: It ain't just a river in Egypt

Bah, I tried to paste in the data from the Spring 2008 Jossart and Cirangle Powerpoint presentation showing FOUR YEARS OUT DATA for the VSG, but It won't paste properly.  The presentation (thanks MacMadame) can be found here: http://www.ssat.com/video/2008/SSAT%2049th%20Annual%20Meetin g(3)-Cirangle.htm

Slide 14 has the pertinent data:  I'll just give their data from their own study, because it was what I was looking for, since they have been pushing the VSG for several years now.

Data summarized for a series of 1000 patients -- the largest published -- using the SMALLEST bougie (32f), and at the low end of the average BMI (46), here are their results:

%EWL
Year 1: 68%
Year 2: 68%
Year 3: 62%
Year 4: 47%

Yup, just as has been predicted.

Conclusion:
"The VSG is an acceptable stand-alone procedure for weight loss in lower/moderate BMI patients when compared with other currently available methods"

Interesting conclusion, when you compare to the results shown on slide 24, which shows the VSG %EWL PLUMMETING between years 3-4.  The trend looks scary to me.

The data for starting BMI on slide 25 doesn't make a lot of sense, unless they are referring to data at 1 or 2 years out.  But it clearly SUCKS for people with a starting BMI >55.

I guess that means they are NOT offering it as a stand-alone procedure for high BMIs anymore?  Oh wait -- yes they are.

And DO check out those DS results on slide 24!!

You're right, denial isn't just a river in Egypt. However, like the river, it has two sides (or banks to continue the analogy).  Most OH DS'ers talk a lot obout their lack of food restriion and weight loss.  However, we hear very little about complitctions snd risks assocaited with this prodedure, both pre-op and post-op.  Surely there must be a few and in order to provide full disclosure, those things should be presented, too.  For example, while a DS post-op may be able to eat 3.000 calories post-op and maintain without exercise, what are the health risks assicated with contnuing to make less than perfecr food choices and not exercising?  Flatulence is an issee I've seen addressed in every DS fact sheet I've read.  Shouldn't pre-ops know about that those  things to?  Quality of life and healthy living are as important than numbers on a scale.  Additionally, when some DS'ers denigrate and humiliate non DS'ers who have made decisions to pursue a differnt WLS based upon their own needs, both physical and psychological, in conjunction with a qualified bariatric surgeion, the last thing coming out of anyone's mouth should be the sentiments that the person is ignorant and doomed to failure.  I don't have any issue with those that chose a different surgery; I most definietly have a problem when some choose to belittle and wish ill-will towards fellow WLS members. 

Can you abuse the VSG and not succeed?  Of Course - just as you can with other WLS procedures.  Regardless of WLS procedure, maintenance is difficult.  I woul think it's more difficult fo those who  chose not to make a lifestyle change in terms of exercise, diet, and possible professional help to deal with fod issues which are commonly related to emotional issues.

Furgermore The EWL% sucess rate fo DS (per LAPSF) is about 80% - so if I chose DS, and lost the optimum amout of weight, and 80%e excess weight loss for me would leave me sitting at a weight of 210 pounds which is still considered obese.  An indivdual's personlal success, in terms the of the number on the scal or BMI on the chart, is very much tied to their compliance to their surgeons post-op dietray and exercise guidelines.  Unfortunately, the types of statistics abiove do not provide informatiomn regarding diet and activity; only the number on the scale.  Her's a link to LPSF's weight loss surgery comparison chart: http://www.lapsf.com/weight-loss-surgeries.html .

As I  have said repeatly over the course of the past 3 months, I wish everyone who chooses surgery success and believe that their success is mostly dependent on their compliance and attitude.  I try not to steer a pre-op to believe that any surgery is a magic bullet and I will encourage them to reasearch all avaiallble options and make the decision that is best for them.  I will not abide, however, with certain populations of the WLS community *****sort to bullying others and presenting only half truths; e.g. those who fail to provide the goodmthe bad, and the ugly.  Lay it all out on the table, the pros and cons, and allow a person to deide based upon the anecdotal and medical information provided.

Amy

Of course EVERY surgery has risks, and DSers ALWAYS tell pre-ops what they are.  The thing is, the risk of NOT LOSING ENOUGH WEIGHT and of REGAIN are the ones where the DS shines.  Taking vitamins, blood testing yearly (or more often if there is a problem to be monitored), and eating enough proten (not hard) are small prices to pay for THAT peace of mind.

Gas is almost always caused by specific foods (different foods for different people, though some obvious ones like white flour and lactose bother a lot of us). which you can avoid at specific times if you don't want to get gas -- but which won't HURT you if you don't mind the consequences -- hardly like risking dumping, getting a stuck stoma, etc.

But as far as health is concerned, the FABULOUS results on cholesterol and triglycerides can't be beat, as well as the nearly 100% CURE rate of type 2 diabetes -- or in my case, the security of knowing I will NEVER get it, despite my family history.

Protein malnutrition is very very rare, and protein supplements can fix it.  Proper vitamin and mineral supplementation is relatively easily accomplished, with commitment to taking them.  If absorption of enough protein, carbs or fat become a problem, Creon tablets supplying pancreatic enzymes can be titrated to increase absorption.  Tweaks to the length of the common channel can be made if necessary, without forfeiting the metabolic benefits.

Every surgery requires a certain degree of compliance.  I don't go hog wild with sugar -- and the DS has as an added benefit to me decreased my interest in eating a lot of it -- sweet stuff tastes too sweet after a few bites -- I really enjoy a few bites and then don't want more.  But the DS is the most forgiving of the very stuff that got many of us fat in the first place -- fat.  Fats make food taste GOOD, give that sense of satiety that many of us spent our lives unsuccessfully chasing, and are particularly tasty and filling when ingested with protein -- and therefore high fat, high protein foods are DS health foods.

The consequences of not getting exercise to the cardiovascular system are to some extent independent of weight.  DSers don't need to exercise madly to lose or keep from gaining weight.  Of course, exercise is important for everyone (dammit -- I still hate exercise, even though I exercise 2-3 times/week now) -- but for me, it is a matter of toning up for reconstructive surgery and strength and balance as I get older -- not to lose weight or because I fear regain.

The DS isn't the magic bullet -- but it's a helluva lot closer to it than the other surgeries for most people.

What do you mean that we hear very little about complications and risks of the DS? We invite you ALL to come on over the DS forum. We are blunt about the issues we face. We tell our stories warts and all. The difference is, there are not that many warts to this procedure!

And who says DSers don't exercise? I sure the hell do. I want a healthy heart and to set a good example for my young kids. I think it sped up my weight loss a bit, too.

I'm SO glad you posted the link to the San Fran chart. I hope those *****ad it see that it says EXACTLY what the DSers here have been saying for the last couple of days about the VSG and its potential problems:

Inadequate weight loss
Weight regain
Additional procedure may be needed to obtain adequate weight loss

THANKS!

Nicolle

I whole-hearttedly agree with you Max_Mom. Frankly, I didn't know a lot about DS, RNY, VSG...when I came to OH seeking answers.But what I found out is that the DSers turned me off with their putting down EVERYONE, this turned me against the procedure and the people. I think every person has a right to make their own decision about their WLS w/o being badgered and put down. I don't care if DS is not well known, force feeding people IS NOT the way to get the word out or telling people that they made the "wrong" choice; it was their choice and they are entitled to it.


You can beat me and others all day long with meaningless stats, who cares. I believe that NO matter what WLS one chooses, if they WORK their tool, they will lose weight. And that this is a LIFE-Long commitment. People re-gain because they go back to old bad habits or did not develop good eating and exercise habits while malabsorption is strong. WLS does not "fail" the person, the person "fail" their WLS.


To DSers, I think you will get more listeners with treating people with descency and respect than putting people and their choice down. You guys come off as non-supportive of others who did not make the choice YOU want. I thought OH was not only about information but also SUPPORT for the Weight Loss choices each individual makes.

"the DSers turned me off with their putting down EVERYONE, this turned me against the procedure and the people."

Wow, still working that genius-level thought process, I see.

Diana (and other DS-ers),

Please don't hate on me for this observation, but at times it really does feel like the DS troops are so passionate about the rightness of their procedure that the passion can cross over the line. Hurtful personal comments aren't a good way to making a point.

Now go ahead and belittle me and my journey. I expect no less these days.

(Ducking)

Passive-aggressive much??

There is history between me and Valueless -- could you not see that?

Take a look at my post below in which I linked to those threads to which she refers -- and which did not go at ALL the way she says they did (notice she didn't link to them??).  Even on the BAF, some of her "sistahs" slapped her down.

Only 2 of the 40 Posts supported YOU, Not the Article. Because I called you a racist and 2 people that you and your Lobbying efforts helped spoke up for you...they did not defend that Article. They also had the DS, so they had to support YOU!  And YES you are a PAID Lobbyist for DS and I know this! These people following you and don't even realize that You are getting paid for bringing people to DS and getting Insurance Companies to change their policies. It's NOT the best WLS, but you don't care, you are just another GREEDY Lawyer pushing a product...You don'y give a Dayyyum about people's lives!

Really -- you KNOW I'm a paid lobbyist?  You mean I get PAID for more than the 70+ hours I work for my employer, a biotech company that has nothing to do with WLS?  Really?  Because I need to get paid more than the mid-six figures I already make at my day job?  From where do you get your information, you lying and very stupid *****  There is no DS organization or doctor who could afford to pay me what my time is worth.

All the work I do for the DS patients (and not the doctors) is pro bono, you stupid, sad, angry, bitter, racist *****  Because it's the right thing to do.  Especially the part where I get the insurance companies to change their policies.  Including on behalf of Joe Madison (DC's "The Black Eagle"), and to a lesser extent my conversations with Santita Jackson (although she apparently pulled some strings [she's apparently got connections better than you or me] at Aetna and got herself approved directly).  Kevin Davy on the Yahoo DS Messageboard is another African Amercian whom I helped, and I do believe a couple of people on that BAF thread had nice things to say about me too.  Check out the people I've helped on the http://health.groups.yahoo.com/group/African_American_Duoden al_Switch_Support/ message board.  Why don't you ask them how much I charged them.

Not defending the article?  Really?  Who said it needed defending?  Just because you don't want to be believe that AAs do more poorly with RNY and Lapband than Caucasians, this is a Vast Whitey Consipiracy To Keep The Black People Down?  You're ******' nuts.