Gastric surgery for Type 2 Diabetes in AB

Hi There!

I am a type 2 Diabetic with severe diabetes and was referred to the Weight Wise Clinic in Edmonton for a referral for gastric surgery to help with my diabetes- a last option.  I was told that a gastric bypass would be very risky and "off label" because of my BMI of 31.  The surgeon said he would discuss with his colleagues and let me know if they would be willing to do the surgery.  Has anyone had the RNY done in Edmonton for diabetes?

I have done further research and talked with several other surgeons in the world and have been told the best operation would be the Gastric Sleeve plus Duodenal-jejunal diversion.  Has anyone had this type of surgery here in AB?  I can get it done in Montreal if needed.

I hope to be able to get my blood sugars into better control and be able to reduce my meds- on max Metformin and 415 units of insulin (Humalog & NPH 4X/d) and stop the complications from the disease that I am experiencing.

Anyone with similar issues please tell me outcomes you have had.

Thanks!

Hi there

I hear the desperation in your posting.  It can't be easy dealing with Type 2 diabetes and is, I'm sure, quite worrisome.

Having said that, however, I have the greatest respect for the doctors and staff at the Weight Wise clinic.  Whatever the decision might be, I would be inclined to accept it.  You can, no doubt, find other surgeons any number of places who will operate but do they honestly have your best interests at heart or are they just looking for another patient? 

The other reason I would accept the counsel of the clinic is that they will, regardless of surgery, help you lose weight.  It just may not be as quick.  WLS is a tool but still requires significant lifestyle changes.  In order to implement them, it is wonderful to have ongoing encouragement and guidance.  I would think this would particularly be the case given your diabetes. 

Please consider all aspects of which ever choice you make.  There is a reason why it takes so long to get into the WW clinic--it's because they are amongst the best!  The doctors are highly regarded in their field.  I would suggest that this alone speaks volumes.

Very best of luck to you as you pursue your weight loss journey!  

Hi,

I have followed my treatment plan with diet and exercise for years, in addition to many various treatment routes and medications.  I am not  overweight other than my abdomen and that is directly related to my diabetes and liver disease.  I WAS NOT referred to the Weight Wise Clinic in itself, but to see Dr. Birch there for a consult regarding an experimental surgery for me- gastric bypass to treat severe intractable diabetes.  I have talked to other surgeons in the world to hopefully see which gastric/intestinal operation would be the most likely to help me.  I was not implying that the surgeons at the WWC were anything but the best.  I would love to have support and guidance in my journey with this but very few people know what it is like to have diabetes to the extent I do, so I do feel alone and overwhelmed at times.  I live as positive as I can but as time goes on and my complications become more and more severe, I am losing faith.  This surgery gives me a spark of hope again but I know with it carries great risk.  I am just trying to find out and research it all as much as I can so I make an informed choice.

Thank you for your comments and words of encouragement.

Hi, I have a bit of an update.  I discussed thoroughly what treatment options I had with Dr. Birch and I am going to have the RNYGB on Jan 29/14.  I have done lots of research on this and I feel pretty confident now that it will improve my situation.  I am still waiting to see what my c-peptide comes back as, to know if it's possible that I can ever get off insulin.  I just want to feel healthy and have energy to do the things I dream of doing before I leave this world.  I am praying that this will give me a renewed chance at life, even if I have to still deal with meds and diet/exercise protocols.  I am hoping to drop to 135 lbs, which would be about a loss of 30 lbs that I need to do.

I will post again once my surgery is done.

Thanks for your help.

I had my surgery and it appears to be successful- I have had normal or almost normal blood sugars since post op- AMAZING considering I was on 300 units of insulin a day and on max dose of Metformin.  I am tkaing 15 units of NPH twice a day now and 100mg Metformin and my sugars are still stabilizinf downwards so may get less doages yet!  So far so good...will update as I go.

3 months post op update- blood sugars are pretty good still, much better than before surgery and my A1C has dropped to 7.3 was over 9 and 11 before surgery.  My blood sugars still climb sometimes but so far I am able to get them to come down.  I am on NPH and Humalog insulin and Metformin.  The RNY was successful for my blood sugar control.  It has a flip side though...I have trouble getting enough nutritional intake now, low on Carbs, Proteins, and fluids.  Feel nauseous and sick lots.  Also have terrible pain all thru my body, muscle cramps, bone pain and neuropathic pain.  Am I happy I did it, well I will still say YES but it is a much less enthusiastic answer than a few months ago.  I guess time will tell if it was a good move- although I was kinda out of options and this has give me more time.

Another update, wish I could have better news but I have had a year from Hell!  Wish I hadn't done the rnygb now, wish I had went for just the intestinal part of it and NOT the stomach portion!  DO not do that!  As a diabetic I cannot get enough nutrition in now to keep healthy.  I now have been diagnosed with Dysautonomia too, with its set of symptoms which I have pretty much all of them!  The RNY helped me for quite awhile but now I am getting more and more brittle with the diabetes- I can swing from being very high to very low in a matter of an hr!  I have lost weight to a point now where if I continue to loose I will be in danger of starvation- weigh 130lbs.  If you are getting it for diabetes alone and not obese- really get lots of research and talk to lots of pts and other docs before doing it.  Wish I would have stuck to my guns and insisted on the surgery I wanted- got talked into something different by the surgeon.  He actually told me he was going to leave my stomach pouch LARGER than normal for a rny, and even on the table before putting me out, I asked him again if that was the plan- he said "yes if he could".  Found out months later, he didn't even try to do that and I have the same size as anyone else- which is a BIG problem for me.  I cannot get enough nutrition in now!  If you have a BMI of 30 or less really insist on knowing what you are getting BEFORE doing it!

I would have never done it!