DS AND Gastic Sleeve

Kathy, people have to take a lot of vitamins with the VSG too. I don't think he could handle those requirements, either.

AND (forgive me because this is one of my pet peeves) it is NOT easy to "go back and have a (DS) revision if the VSG does not do enough." That is what we often hear from the VSGers who merely WISH it was true so that they have a back-up plan.

First, by the time you need to get a revision, your stomach has stretched out all to hell and back and you would need a re-sleeve, which is very tricky, as the tissue is already severely compromised. Also, it is unlikely any insurance will want to pay for a part 2 of a surgery unless you have severe medical need.  And many insurances are now starting to have a "one bariatric procedure per lifetime" clause. PLUS, it's major surgery. Think twice, cut once.

It's NOT easy to get the part 2 added like an a la carte menu.

(Getting off soapbox now.)

Nicolle

The sleeve is not likely to strech out to all hell and back. Maybe a little but not enough to require a resleeve if done correctly the first time. They are made smaller now for the stand alone procedure than I believe they were in the beginning, and (I think) smaller than the DS I think too since more restriction is needed in the absense of malabsorption. I just asked this question on the VSG board and from the responses, and other posts I've read in the past restriction is still very good at 2 years out.

Also, vitamins yes, but not to the extent of the DS for most people. I'm sure that varies by individual and their needs.

I do not plan on going back for a revision, but for informations sake my health insurance DOES cover the two step approach for persons with a BMI over 50. The BMI of 50 requirement is also the only way they'll approve the sleeve as a stand alone.

That said, I agree with you "think twice cut once". I would not want to go through another surgery with the risks and recovery associated. Also the DS is more effective when done all at one time correct? If that was the surgery I felt was best for me I wouldn't waste time doing a two step approach. The DS is a great surgery and had I wanted malabsorption the one I would have chosen. The sleeve and the DS are the only two I considered for myself. But, this is the second time a DSer has posted tonight/today about the sleeves stretching "to all hell and back" and "to the old tummy" size. Which is simply not true. Does the DS sleeve grow back to the full size stomach it used to be? I don't think so. Perhaps I am wrong about that.

Don't you know?  The sleeves stretches back to the original stomach when it's a stand alone procedure.  When it's done as DS it doesn't stretch as much.

And we ALL know that with DS you can sit and eat cake and full sugar soda all day and be a size 2.

Oh... and DSers stink.  You knew that too, eh?

You are a month out, right? It was hard for me to think I could ever eat again at that point, either. Just wait.

I have had my sleeve for over two years now. I think I know what I am talking about.

My stomach was the longest my doc had ever seen. I know my stomach will never get back to that size. But it has gotten much bigger.

I even started with a smaller sleeve than most of my DSer counterparts and some of the VSGers I know--80mL. Allegedly that is about 1/3 of a cup in volume. I can tell you that I now can put away 10x that much in food at a sitting. Easily. And to get in the protein we need (80-120g), the calories can add up and the weight starts to pile on.

Without malabsorption working for me, I would be on the regain side RIGHT NOW, even though I do exercise.

NO ONE plans on getting a revision, but the VSGers like to keep "it's easy to switch to the DS" as their fallback. I am here to tell them that it isn't so easy.

I hate to break it to you, but VSGers need to believe that their stomachs will not stretch. It is in their best interest to believe that restriction will last forever and that they will be good dieters forever. I would expect all of them to say they have fabulous restriction when asked. Those who do not have good restriction drop off the board or hang out on the revisions board.

I even saw that one of the most successful VSGers on the VSG board (actually kept weight off past 3 years out) recently suffered an exercise setback (injury) and started gaining weight. This person is a major exerciser, riding her bike miles and miles each week. That's a lifestyle that is hard to maintain for life. A lapse in exercise or calorie-counting can really get you off-track.

I know some docs in SF are advocating teeny stomachs cut at a certain point to stave off the 3-4 year regain they are seeing. We will have to wait and see how that works out. The danger of that is the higher potential for leaks and complications. We'll see.

You say your insurance will cover a part 2 surgery. What is the VSG gets you down (like most surgeries will) to a lower BMI, say 34. You're still obese, but you don't qualify for WLS anymore. Will your insurance cover it then or will you just settle for that weight? Most people settle and then start regaining even more. Those who go forward often need to get re-sleeved to start the synergy working for them. They even may have to self-pay.

As to vitamins, I take only 12-13 daily, and 10 of them I would be taking just because I am a woman of child-bearing years who lives in a cooler climate (calcium citrate, vite D and a multi). Each person is different. Some VSGers take faaar more than I take--I have asked the VSG board and I read the VSG board almost every day. So I have to point out when people say they want the VSG BECAUSE they don't think they will be compliant with the vites of a DS that they should watch their step or they will become malnourished.

If you are fat enough to require the malabsorption part to be added to your sleeve, your sleeve is very likely to need some tweaking via revision. That is major surgery on already compromised tissue. Think twice (even three times) cut once.

So that's from a two+ year sleever talking.

Nicolle

I never said I didn't think I'd be able to eat again. I agree it will strech somewhat. I think "To hell and back" or to "full size" is a blatant exaggeration. I realize I am one month out and that is why I asked others who are farther out.

I may have been "fat enough" to have malabsorbtion, but I did not feel I needed it. I am 24 years old and to be very honest I question what that does to ones body after say 50 years. If anyone on here is 50 years out have them PM me. That is only one of a few reasons I did not choose the DS.

To be honest, If I have problems losing or with regain with my sleeve I would probably have it with the DS as well b/c my problems have to do with CARBS. I don't believe the DS malabsorbs those. 

Bottom line, I appreciate that DSers want to make people aware that it is an option and make sure that there is accurate information out there. I get that. But to say that people should be informed of all options and make the best choice for them (I know you didn't necessarily do this) but then seem to put down other surgeries, or misinform about another surgery seems hypocritcal to me.

Its like people who try and talk about being respectful of all beliefs but then say if you don't believe what they believe you're going to hell. I don't want to start some sort of surgery war or get people jumping on my back, b/c again I do support the general idea of spreading information. And its no skin off my back if someone decides they want the DS instead of the sleeve, or the RNY instead of the DS. I would rather they choose the surgery they can live with after researching all the options and wish them well. We're all on the same team so to speak regardless of surgery choice. You baiscally just told me I am going to remain obese and fail b/c I did not choose the DS right? Thanks for the support.

Do you have a reading comprehension problem? I never said you would "remain obese and fail b/c (you) did not choose the DS." Gimme a break.

To "hell and back" is clearly subjective because I have never been to hell and back. I can tell you my stomach seems as if it has stretched 10x the size it was made during my DS. To me, that is pretty damn much, but it is nowhere the near the size of my stomach before my DS. It WOULD be hellish if I regained the nearly 200 pounds I lost because my damn stomach stretched. I am grateful for the malabsorption of the DS. I have been using it well already.

Believe what you want to believe, or NEED to believe. If anecdotal cheerleader-style info is what you need to feel comfortable with your choice--not data--so be it. Ignore anything you don't like. I'm sure it will all just work out fine.

Best of luck to you. I hope you beat the odds. I hope we all do.

Nicolle

Subjective maybe, but if I were a pre op who didn't know much about sleeve reading that statement would certainly put a lot of questions in my mind and bias me against it.

I do not have a reading comprehension problem. How polite you are. It just came across as implied to me. But I apologize for getting that meaning. I can tell by your tone you obviously don't mean to be rude.

I do not need to believe anything. I can talk to people who have thus far been very successful with the sleeve. I am not ignoring that the DS has good data to support it. I clearly said I considered it and decided it wasn't for me. I am happy you are happy with the DS and that it is working wonderfully for you and others.

As far as sleeve data, I am quite aware that the long term data is lacking. From the data I have seen it does not seem very dire. As far as that goes, I may not be able to back up my surgery with years of data, but you also can't fault it due to the same problem. It may be in 10 years the data proves the sleeve to be successful. Who knows. I do think a lot of success probably has to do with patient compliance and surgical skill, but that is true across the board. I made the decision that I felt was best for me after doing reasearch. I am not ignoring anything. I don't know that there needs to be "cheerleading" going on all over, esp if there is a real problem. But support and "cheearleading" are not the same thing. Perhaps that is subjective also.

My main concern was really this...if someone asked me about the DS I would tell them to research it and talk to people like yourself who have had the DS. I would not run down a list of negatives right off the bat, because I cannot not possibly know what life is really like with a DS. I am just of the belief that if people have a question about any of the surgeries they should speak to those that have it done. And people who have had surgery should probably stick to discussing the one they have.

Ignore her.  She's another one of "them" vs. a normal.

Sure, your sleeve is going to stretch and it's going to stretch out most in the first 6 months post op.  It's supposed to.

I am also 2+ years post op and this nonsense about it stretching out x10 is either total BS or her surgeon is an idiot.  I can eat 3oz of solid protein or 5oz of soft foods.  If my sleeve stretches out double what it is today, I do not care.  If an extra 3oz is going to get me fat, DS isn't going to help me either.

You are incapable of managing the DS or the RNY. Don't get either one.

In the VSG they remove all but a tiny bit of your stomach so you can only eat a tiny bit of food at a time.

Do your own damned research.