Pre-ops: Make sure you learn about the DS before you chose your surgery!

(deactivated member)
on 10/24/09 2:43 pm - San Jose, CA
Nothing makes me more upset than to hear about someone who has some other surgery who is now struggling and wishing they had the DS, especially when they say that they had never heard of it, or had only heard lies and exaggerations about how "big" or dangerous a surgery it is, compared to the others.

The DS is, on average, the most effective of ALL of the weight loss surgeries, and the easiest to live with.  It is the most malabsorptive, but allows the most normal eating of any of the surgeries (in fact, better than normal, in most DSers' opinions), and the best chance of losing the most weight and the best chance of KEEPING that weight off long-term.  Keeping healthy means eating a high protein, high fat diet (which DOESN'T suck!), taking supplements (generally a couple of handfuls a day) and doing labwork and adjusting if necessary.

It has no greater surgical risk in competent hands.  There is NO reason to reserve it for the super morbidly obese, because it can be tailored to the patient, by adjusting the lengths of the alimentary tract and common channels, as well as the size of the gastric sleeve.  There is no dumping, no risk of marginal ulcers -- we keep a normally functioning stomach, with our pyloric valve, that is simply made smaller along its lengtth (the sleeve gastrectomy) -- over time, it stretches out to be about 2/3 the size it was before surgery, so you can eat a small normal meal -- then the intestinal bypass helps keep the weight off.

It is, however, the most technically difficult surgery to perform, because the surgeon must be quite skilled in suturing duodenal tissue, which is difficult to work with, and so it can't be learned in a weekend seminar.  DS surgeons typically must proctor with an experienced DS surgeon, and most general or bariatric surgeons don't care to take that kind of time to learn a new procedure -- especially when some of the insurance companies don't make it easy to get authorization for it.  Nevermind that it might be better for their patients -- follow the money! 

The worst thing about the misinformation that is promulgated about the DS is that much of it comes from surgeons who are not qualified to perform it.  They cite outdated statistics, including statistics that confound the results of the DS with those of the BPD (an outmoded predecessor surgery), and that don't take into account that earlier studies included a disproportionate number of the heaviest and thus sickest patients.  They also say that DSers have uncontrollable gas and diarrhea.  These are unconscionable lies.   I guess many bariatric surgeons feel the RNY, VSG or Lapband is "good enough" for most of you. 

The DS is in most cases (>98%) a CURE for type 2 diabetes.  Even for those DSers *****gain a little weight after hitting their low, the diabetes almost NEVER comes back.  This is not true for RNY, VSG and Lapband -- and those procedures have a much higher risk of regain, and in particular substantial regain.

The DS also cures hypercholesterolemia, hypertension and sleep apnea in the vast vast majority of cases, and again, even if there some regain, these co-morbidities almost never come back.

Do yourself a favor -- before you hop up onto the operating table, make sure you understand the TRUTH about the DS.  Come over and read our posts on the DS Forum and learn the FACTS before you settle for what your local, in-network surgeon is willing and able to give you.
dustypages
on 10/24/09 2:55 pm - In America, KS
I have had the DS nearly a year ago.  I am a light weight.  My BMI was @35.2 the day of surgery.
Within 3 months, my HA1c was to 7, where three months previous it was a 12.x.  At 6 months it was around 5.  I will have another in January.  

If you are a light weight or diabetic or just need WLS for a better healthier way of life, look into the DS.

I went to my surgeons office to consult about the lapband, did not want it.  Went back for another consult with another surgeon in the same office for the RNY, did not want that.  Read in the flip chart they showed me about the DS surgery.

Went home researched, researched and researched some more.
With in 4 months I was scheduled for the DS.

I am below goal weight.  I don't wake in the morning opening one eye at a time, hoping that I had not gone blind.  (I was getting bleeds in the eyes, motivation for WLS).  Although I am below goal, which was a BMI of 25, I am below as in a BMI of 22.2.  Still losing little bit here and there.

I love life.  I don't feel a prisoner to myDusty body and it rapidly dying.  I wanted to see my 3 year old grow up and I want to see his babies, and I want to see their babies.  I now feel like I will live to be a very old woman rather than the thought I had that I would be very sick for a very long time, but be dead by 45.


Dusty








moonboots
on 10/24/09 4:03 pm
I would totally get DS if my insurance covered it, and there is NO WAY I could fund it myself.
Create in me a clean heart, O God, And renew a steadfast spirit within me. psalms 51:10
          HW:325/Pre-OP W:253                    
Beam me up Scottie
on 10/24/09 4:06 pm
appeal?
(deactivated member)
on 10/24/09 4:06 pm - San Jose, CA
What insurance do you have?  What state do you live in?  Is your plan fully funded or self-funded?  What does your exclusion language say?

Most denials of the DS can be overcome.  More and more insurance companies are covering it.
purple_69
on 10/25/09 3:18 am - Prosser, WA
Thank you all for posting this info about DS, I hope all who are planning wls will read these posts and reconsider having the DS if at all possible!!  After reading these posts, I for one am feeling a little depressed!  However, I am thankful to have been able to have surgery and lose weight, (without it I would'nt have gotten nearly this far!), but I hope that I can continue to control myself and not end up as one of RNYer's *****gain!  Thanks again for the great information!
        
Beam me up Scottie
on 10/24/09 4:05 pm
AAAAMMMMEEENNNN

What kills me is that doctors are still recommending the RNY for patients with diabetes who have BMIs over 50, when all the documented evidence points to the fact that the DS is a much better surgery for someone in that situation.

Scott
moonboots
on 10/24/09 7:16 pm, edited 10/24/09 7:17 pm
Kaiser Permenente, Oregon....all surgeries have a $500 dollar co pay, I'm going to look into the details a little more.

Thanks for the reply! ^_^

Create in me a clean heart, O God, And renew a steadfast spirit within me. psalms 51:10
          HW:325/Pre-OP W:253                    
(deactivated member)
on 10/25/09 12:03 am - Woodbridge, VA
I know KP in CA has been forced MANY times to cover the DS. I recommend coming and asking about KP in OR on the DS board. I'm pretty sure KP's only reason for not wanting to cover the DS is that they have no DS surgeons in their network.
(deactivated member)
on 10/25/09 3:07 am - San Jose, CA
Kaiser has been forced to cover the DS in CA without exception for the last 5 years.  A Kaiser Colorado patient just won her appeal as well.  These cases could be cited to Kaiser, and to the external medical reviewer for Kaiser OR.
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