BMI 35 and surgery

Brad Special
Snowflake

on 1/15/15 4:18 am
VSG on 12/06/12

Last I checked they don't staple stomachs anymore. They do RNY, sleeve, DS, and lapband for the most part. You may be the exception I see people on here all the time that had reversal of diabetes with RNY.

Seabiscuits
on 1/15/15 9:37 pm - Norman, OK

Protein or fat is actually important to eat with carbs to keep your sugar up. I am surprised they said eat carbs following sugary foods because carbs turn to sugar and that will spike you higher following by a quick drop. Our bodies just don't process sugar like it should. Unless we eat whole grain then we shouldn't get as much of a spike and less chance of a low. I am worried about that, tho. I can imagine it's hard to eat to keep your sugar level up when your stomach is too small to eat much. 

bhfg
on 1/15/15 2:28 am

I can comment quite a bit on the NASH liver condition.    Although it really doesn't make a difference, one thing you may want to understand is if your liver consider came first or if the weight came first.  Excess weight is a very common cause of NAFLD that leads to the more advanced stages called NASH.  But if you damaged your liver other ways, it can also contribute to the inability to lose weight. Regardless, trust me that they are related. Next to alcohol, the excess weight is your liver's worst enemy.

So you can have some trust in what I say, here is a little background.  I have a type of NASH caused by exposure to toxic chemicals in the Marines back in the late 70s (TCE, PCE, Benzene, Vinyl Chloride).   In 3 years I went from 198 lbs to nearly 250 lbs while running marathons, on a protein shake diet and still scoring first class on the Marine physical fitness tests.   For about 35 years we did not know what caused the disease until the Marines contacted me as part of a health study a few years ago.  Now we know.  My entire adult like has been a struggle with weight maintenance and liver function, and I am now 415 lbs with a 59 BMI.  I was first advised to consider WLS about 10 years ago.   I studied medical journals, read medical trials, read heptology text books and consulted several liver specialists. But the more we I researched it the more we felt the increased risk to my lever was a non-starter because the rapid and significant weight loss put too much strain on an already damaged liver.   But things have now changed. There are improved procedures, better post-op care, and more is understood about how a late-stage NASH impaired liver reacts (mine is late Stage 3 with 60% Fibrosis).  You have options.

Once you get to where you are, your liver is probably not able to properly process the fats, toxins and poisons you consume and Therefore, losing weight is even more impossible.  You can think of it a having Metabolic Syndrome on steroids. But with current types of WLS you can help offload these compounds from your liver, and with improved lifestyle and dietary changes you stop consuming them.  Your liver will start to become enlarged, filling up with salty fluid and then you start developing fibrosis.  Al that make it even harder to get the things your liver processes though the tissues and chambers, and increases portal hypertension.  Left to keep going, the fibrosis starts to die off and form scar tissue which is called cirrhosis.   But you can beat this.

Talk to a WLS surgeon familiar with liver disease to know for sure. But everything I have studied and learned says RNY is the "gold standard", especially in the case of liver disease because it is both non-absorptive and restrictive.  It has even been shown to result in a full "stage improvement" in later stage liver disease.  In many situations today, if a person has a liver transplant, they get an RNY at the same time to help protect the new liver.  But, if your BMI gets too high, like mine, your liver gets too large, like mine, or other complications form, or your are a high likelihood candidate for a liver transplant later, RNY may not be a first option.

VSG is a newer option.  While it does not have the non-absorptive benefit, it does have the restrictive qualities, and then with the lifestyle changes YOU make you lose weight and increase your liver function.  It has not been around quite long enough to know if it can offer a stage improvement in liver disease like RNY has done, but early results are already showing that it can help stop the progression. And it makes it easier if you have to have a liver transplant at some time. If you are as big as I am or the liver is as large as mine, surgeons sometimes do a 2-stage of a VSG followed later by an RNY if it is needed.

After 10 years of research, studies and problems, I finally found a surgeon (Dr. Chris Hart at Atlanta Bariatrics) I trust that took the time to understand my liver condition concerns, and has been working with me.  I am now scheduled to have VSG on Feb 3.

Are you nuts to want this?  NO!   I would say you would be nuts not to consider it. You have better options and prognosis the earlier you take action.   

I wish you good luck and encourage you to read everything you can get your hands on.  Remember that if you read posted studies about liver and WLS on the internet, be sure to look at things newer than about 2009. Seems things started changing about then.

 

Seabiscuits
on 1/15/15 9:47 pm - Norman, OK

First of all, thank you for serving our awesome country. My son is a Marine - Ooh Rah! 

 

Second of all, thank you so much for this incredibly well-informed Post. I will definitely read up on the WLS and liver issues. Ever since I had my gall bladder out this past March it seems as of it's harder for me to lose weight and harder to digest food. I understand that the liver/gall bladder/pancreas all work together. It so happens that I had pancreatitis caused by my gall bladder so I don't know if all of those things combined with my NAFLD make things harder on my liver or not. Something else for me to read up on.

Congrats on your upcoming WLS date! I wish you quick healing and great success. 

 

Thanks for for all the great information. 

Cindy

KattattaK
on 1/15/15 11:41 pm

Great info!!!!

MsBatt
on 1/15/15 4:23 am

From other boards, I know several people who had their DS (duodenal switch) with a BMI lower than yours, strictly because it was their best chance of reversing their diabetes and/or high cholesterol. In fact, surgeons in Europe have been doing just the intestinal part of the DS on NON-obese diabetics, with remarkable results.

About 85% of diabetics who get the RNY achieve total remission, and better than 98% with the DS---but there's no guarantee for any given individual. The key seems to be how long and severely you've been diabetic, so my advice would be do it as soon as you can.

 

Seabiscuits
on 1/15/15 11:49 am - Norman, OK

And to be honest...I'm not sure what my cholesterol is. I think my triglycerides have been high in the past. 

I have been diabetic for awhile but not on insulin. That will probably be my future if I don't get my weight turned around.  Thank you for the advice. 

Seabiscuits
on 1/15/15 11:47 am - Norman, OK

Thanks for everyone's replies. I really think this will be the best thing I could do for myself to better my health. 

southernlady5464
on 1/16/15 7:41 am

My pre-op BMI was 35.2.

I was on an insulin pump (type 2 diabetic), PCOS, high cholesterol and sleep apnea.

I had the Duodenal Switch almost 4 years ago. I got the DS because I wanted "one and done" and knew I HAD to have NSAIDS. Can't take NSAIDS with the RNY.

My current BMI is 22.8.

Duodenal Switch (Lap) 01-24-11 | Surgeon: Stephen Boyce | High weight: 250 in 2002 | Surgery weight: 203 | Lowest weight: 121 | Current weight: 135 | Goal weight: 135






   

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