Very High BMI...preparing for self-pay VSG in 20 days...what do I do?

I had fasting blood sugar of 200 and was about to go on insulin.  Day of surgery it was way higher, since stress spiked it.  I lost 140 pounds the first year of surgery and had my diabetes resolved completely with the sleeve.  My fasting blood sugar is typically 70-85 now. The morning the day after surgery, my fasting BS was 76.

Don't get me wrong - the RNY is fabulous for both those things, but we still see diabetes resolved too.

Would I have lost more with the RNY? Maybe.  It's debatable.  The current research shows very close numbers with little variation.  I may end up needing the DS eventually (the reason I picked the VSG), but we will see.

You definitely can see a good resolution of diabetes and significant weight loss with the VSG, too, though. 

The VSG chance is 50/50.  My doctor says it is a coin toss whose diabetes gets resolved.  With RNY it is closer to 75%.

I had diabetes Type 2 for 20 years before surgery and had been on insulin for 10 years. Mine did not resolve with RNY but was much improved for about six years.  The longer diabetes goes on the worse the state of the pancreas.  Being on insulin seems to also decrease chance of resolution, especially if for more than five years.

If I had known about DS, I definitely would have done that.  My choices were lapband or RNY.  I did not know about DS until after my surgery.  I consulted a DS surgeon who told me that he did not believe DS would have helped me because of my long time diabetes and insulin use.

The quicker you get surgery, the better your chances of your pancreas working correctly again.

Sounds like you're doing the right things. I would suggest searching this forum for any questions that come up (of course, MD-appropriate questions need to go through your MD, but this forum is a great resource for pre-op and post-op hints). 

Practice taking tiny bites and chew everything to a pureed consistency. Practice not drinking while you eat. These are things that will need to happen post-op and the sooner you make it a habit the better. Start cleaning out your cupboards and replacing your food hauls with nutritious, low-carb items. Get used to low carb eating right away. The more weight you can lose pre-op will make your surgery safer and recovery easier, but definitely don't skimp on the protein and water.

Best of luck to you!

Thank you, McLassie! I have been researching 'Bariatric Low Carb meals' on Pinterest and found a BUNCH that sound delicious, healthy, and that my kids will eat. 

I haven't had surgery yet, and I don't know anything about diabetes, but the Phentermine, OMGOSH, the only thing that pill is good for is to make your heart race, lose weight ONLY while you remain taking it and lastly, keeps you up all night. I would absolutely ask your doctor about taking that medicine prior to surgery and it's contraindications for a successful recovery. It kind of messes with your mind as well and can be addicting even though over prolonged use, it loses its effectiveness. PLEASE ask your doctor about that before you start it or continue with it. Good luck with your surgery!!! 

Hi Secrets,

Yes, I know. I've taken it in the past. I do not want to create any heart issues right before surgery. So...if I can survive this protein shake 3 weeks diet, I will just bite the bullet! 

Have you looked into the DS? With your diabetes, it has the best success rate of curing diabetes. 98%I believe.  It also has the best results for maintaining weightloss. However it is the most malabsorptive, so vitamins and lab check for life is a must.  

I started with a lap band, then self paid for a vsg also in FL. Are you using Dr. Shillingford? Now I have the DS, I wish I knew about the DS earlier. 

Yes. I WANT the DS VERY BADLY. My husband is VERY unsupportive and the cheapest option is the VSG. And since I had massive complications after C-setions with infection the surgeon I spoke to in the hospital after my youngest child's birth in 2014 told me that he recommends I at least TRY the VSG. Because it can help people get off a lot of weight without the risks of infection that cutting the intestines does. I had MRSA in my c-section wounds...TWICE. Had to spend a month in the hospital with open wounds then go home to a wound packing nurse...TWICE. 

The sleeve is the first portion of DS, so there is the option of getting the switch later.  Best of luck.

Forget the Phentermine... you will be able to do the liquid diet. Is it easy? No. But it is just the beginning there are a lot of adjustments to make.

I realize you are self-pay so the sleeve is probably cheaper, but I hope you have at least considered the RNY/gastric bypass. Many people write it off too quickly because the sleeve seems 'less invasive' ..... but you want the best result. You have a high BMI and are on insulin, both factors to consider.

I was Vitamin D deficient for well over a decade pre-WLS... I only in the last 2 years discovered liquid Vitamin D, it is finally solidly into normal range. I worked my self up to 20,000mg a day based on my bloodwork. ( I know sounds crazy...even to the Doc)... but that is what I take.