Need Help with WLS Type

Hi All,
 

I am 47 years old, wiegh 250 lbs at 5'8".  I had lap band in 2008 with no real weight loss results although I was complaint-no soda/ caffiene etc.  Now I am self paying for a revision.  Intially, I was planning on by pass until my surgeon Dr. Daniel Cottam (SLC UT) higher incouraged DS.  I have sepnt months on a by pass forum where most participants think DS is ONLY for morbidly super obese BMI over 55.  My surgeon is very postive of DS over by pass long term.

I am scheudled for surgery on 22 Oct with a two week liquid diet prior. My surgeon said I can make my final desision the day before.  Needless to say, I am VERY stressed.  I am truley looking for your perspectives-any advice is greatly apprecaited!

Julie

Your surgeon is right - the DS has the best statistics of any wls, esp when you look longterm, for percentage excess weight loss, for MAINTAINING that weight loss, and for resolution of almost all comorbidities. Weight regain is the dirty little secret of gastric bypass, and thankfully it's becomming less of a secret nowadays, though that doesn't help the patients who experience it. It's just that so many people do well with it at first, and then either never get even close to goal despite doing everything right or regain despite doing everything right that this if finally getting some attention.

The people who are telling you that the DS is only for the SMO (usually defined as bmi over 50, not 55 btw) are mistaken. This is outdated thinking. When surgeons first started doing the DS, they did "reserve" it for people with higher bmi's, but now it's been shown to work well (again, better than any other wls) for patients in the 35 - 50 range as well. It was initially thought that the complication rate was higher with the DS, but that was because the first patients were larger and sicker. If you compare similar patients, the complication rates are the same.

Larra

ps - I'm also sending you a pm.

In addition to the great info from Larra, you may want to have a look at these links as they comapare RNY and the DS.  

 

http://www.obesityhelp.com/forums/amos/3463340/US-vs-THEM-Wh y-I-chose-my-surgery/

 

http://www.dsfacts.com/Comparison-of-DS-and-RNY.html

 

As the saying goes 'think twice, cut once' or only once more than you've already have ;-)  Being a revision, you're likely to lose more slowly so you want the best surgery available.

 

The only thing is that Dr Cottam isn't a vetted DS surgeon so that'd be one BIG reservation I'd have.  I am but a babe in the DS world (9 weeks out) but I've had a very easy time so far and I have to attribute that to my surgeon's skill.

Vetted surgeons are listed here http://www.dsfacts.com/duodenal-switch-surgeons.html

Julie, I chose the DS because I needed NSAIDS and wanted the best malabsorptive procedure for me. I had trouble finding a surgeon who would work on a lightweight. But more and more are.

My BMI pre-op was a grand whooping 35.2...I BARELY qualified.

You can find more of us here: www.obesityhelp.com/forums/wls_lightweights/

Liz

Thank you so much for the responses thus far.  As I am self pay, one area that concerns me is the lack of BLIS coverage for this option.  My understanding of BLIS is that is covers any complications.  I have TRICARE insurance so am a bit confused about what happens if there are heaven forbid complications.  Were any of you self pay?