A Crossroads:The Sleeve or Roux and Y???

my BMIis 43 and 201 was a good wieght for me since i am a 5'10' woman. But if i get down to 180, i wouldn't mind. DS, ha... kaiser doesnt mention that procedure AT ALL.

They may not mention it but you can come to the DS forum and meet other Kaiser patients who HAVE the DS or who are currently going thru the Options program.

~Becky

With the DS I think you have a chance to  get down to 160 which would put you at a normal weight and a BMI of 23.

I was a 41.5 BMI at 5'7" (265 lbs) and I am now at a low normal BMI at 118-120 pounds at four years out.

The DS provides the highest percentage of excess weight lost AND the highest percentage of excess weight loss maintained long term.

You are lucky being in SOCAL. Your insurance HAS to pay for it and you are close to a choice of highly renowned DS surgeons. Many of us have had to travel. Definitely swing by DSFacts.com and the Duodenal Switch board here and look into it. You won't find many unhappy DSers.

Best of luck!

It's VSG for me. I am 311, 5'3", 45yof:

My decision is based on being a volume eater. My big ol' tummy is like a bottomless pit. It's always screaming - feed me, fill me up! So, I need restriction. And I'm good at losing weight, just not good at keeping it off once I stop dieting and go back to *my* normal (excessive) portions.

I am not good at keeping up with meds on any schedule. I take two blood pressure meds... sometimes in the morning, and sometimes I forget until evening. I don't want to keep up with a drug schedule required by those with malabsorptive procedures. While the majority of people I know have done well with RNY, there are a few with complications that, quite frankly, nearly scare my granny panties off me. Anemia, vitamin deficiency, weight regain, dumping... not my cuppa' tea.

If, IF, I don't see the weight come off with VSG, then I must re-evaluate the above med statement. At that point, I will likely have to suck up my lackadaisical attitude toward meds/vites and convert to DS.

The VSG hasn't been proven for a long length of time as a stand alone procedure, but it has enough backing behind it as part of the DS that it's safety has pretty much been proven. I prefer to go least invasive, most easily manged first... so that puts VSG before DS in my case, but the DS is my ace in the hole, if need be.

I will not do RNY. I prefer to keep my stomach functioning as normally as possible, just with a much smaller capacity and would rather have the excess out as to leave it hanging. Greater weightloss? I dunno. If you use the VSG as some of the poster's here do, they're as successful as any RNY'er. That said, I'm not downing the folks who chose RNY. They have their reasons for choosing as they did.

You do realize that with just a VSG, your stomach will stretch out right about the time you want to go back to your "normal" portions and your restriction will not be as extreme as you seem to be counting on, right? You WILL be able to increase your volume, just like you did before. If you don't need help losing the weight, just keeping it off, the VSG is the opposite of what you want.
 
I understand that the DS is your "ace in the hole" but I think you need to do a little more research. Two things I'd like you to know to start you off: 1) Even with "just" a VSG, you will need to supplement for life, at the very least, 2 multivitamins, 1500mg minimum of calcium (split into 3 separate doses), and B-complex vitamins EVERYDAY FOR THE REST OF YOUR LIFE. 2) Having a 2 part DS is NOT as effective, weight loss is slower, there are 2 surgeries to recover from, and your chances for losing 100% of your excess weight go down.

www.dsfacts.com

Before you decide, LEARN. Not just about your surgery, but the differences between all 4. It DOES make a difference.

Thanks.  Yes, I've done my research - 10 years of it actually - and am very comfortable with my choice.  
 
I'm medically savvy, and certain I have a grasp on the difference in the procedures and the requirements of ea*****luding degree of supplementation.  Again, if they way I take meds isn't working,  I'll suck it up and do what I need to in order to stay healthy.  I also realize a DS revision will mean more surgery.

Not sure about the normal portion comment???  I have no expectation or desire to ever be able to eat the amount post surgery as I can eat now. Not even close!!!  By following the tried and true VSG post-op dietary guidelines for the rest of my life, there really is no reason to expect it will not work.  But, if it doesn't, heaven forbid, then yes, the DS is still an option, revision pitfalls and all.

I'm very pleased you're happy with your surgery.  And you have made valid points.  Have a great day!       

Once you have a sleeve you never can *really* get a DS.  The magic of the DS is the comination of the restriction (that goes AWAY over time) with the intestinal switch and that only happens when you get the full DS all at once.

A DS done in two parts is just not the same AT all.

And your sleeve WILL stretch.

~Becky

Good post April.  Thinking that getting the switch IF the sleeve doesn't work is a good plan B is foolish.  Very foolish.

~Becky

I know everyone has their own reasons for which surgery they chose, but here are mine:

- I absolutely wanted to keep the pyloric valve intact.  It seems that many of the problems RNY's have with regain can be traced back to not having a pyloric valve.

- I need to be able to take my NSAIDS.  I take them for issues that have zero chance of being solved with weight loss, so I need a plan that makes it safe for me to keep taking them.

- I did not want the remnant stomach to be hanging around where it could cause trouble but not be investigated without significant surgery.  I'm pretty young, so I (hopefully) have many decades left for that stomach to sometime cause me problems.

- My surgeon's average excess weight loss results between the RNY and VSG are about 7% of excess weight.  So for me, with about 140 lbs to lose, that means a 9.8 lb difference.  Frankly that is not nearly enough weight to sway me to RNY.  And I am confident that I can do what it takes to make up for that "average" difference anyway.

- I did not want to be swallowing pills (or otherwise taking vitamins) all the time, as is the case with the RNY and even more so with the DS.  A) It makes me feel like I am sick/have some chronic health condition - which is NOT how I want to feel anymore, and B) I don't want be stressed about having malabsorption for the rest of my life.

- With the DS, it seems that for maintenance, you must eat a great number of calories in order to get the nutrition you need.  And alot of fatty food too I think?  Frankly, I don't want to be eating that much anymore.  When I'm emotionally eating, I feel like that is all I do.  And I don't want to feel like that ever again - hence the reason for the surgery.  Its not natural to eat lots of high calorie, high fat foods, and stay fit and healthy, and I just can't see that being a solution I'd feel good about.  (Remember, I'm talking about me only; I know it works for other people).

- Also, with the DS, it seems like there is alot of pooping?  Not to be to graphic about it, but frankly, I've been in both scenarios, and I really like the dramatic difference in bathroom habits between eating healthy moderate amounts of food and eating 3000 fat and protein calories/day.

I hope some of that is helpful to you!

(Edited to change DS to VSG in the point having to do with excess weight loss percentage)

.