Nervous and trying to decide what procedure to have.

Hello everyone. I'm new to all of this, and am a little overwhelmed. I've finally decided to have weight loss surgery after having to take a hiatus from nursing school due to medical issues directly related to my weight. I currently weigh 338 pounds, my heaviest. My insurance has approved surgery pending the psych evaluation I'm having done next week. Originally I wanted to have the DS, but I'm concerned about the increased risks and longer recovery time versus the gastric bypass. Having bariatric surgery is a major decision, and I want to make sure I make the right choice. I know ultimately this is a decision I have to make myself, I'm just hoping to get some opinions from others who have had both procedures, and what helped you chose that procedure, and are you happy with the procedure you chose. I was told by the insurance specialist where I'll be having my surgery that the DS is mostly reserved for those with a BMI of 60 or greater. I'm not sure if my surgeon would discourage me from having the DS because of this. I have been heavy most of my life, and I'm so tired of fighting the yo-yo dieting. I know I have to do the work no matter which surgery I choose. I just want to set myself up for the best outcome possible. I'm ready for this change, but I'm scared as well. I apologize for my lengthy post. Any advice would be greatly appreciated. Thank you for taking the time to read.

Andria R.

I can't DISAGREE more with what you were told about the BMI of 60.  The truth is that it's the most recommended (not reserved for) for those with a BMI over 50 (not 60), and the requirements to get the DS are the same as any other procedure (BMI 40 or 35 with comorbities).

In the hands of a skilled experienced DS surgeon (and I stress this detail) - the DS has no additional surgical risks. 

For recovery time, I see the same variables I see on other procedures, anywhere from 2 weeks to 2 months.  Much just depends on the patient.  I was a cheap date to anesthesia.  My incisions healed in 2 weeks, but I was so listless with my brain in a fog for about 6 weeks.

Well congrats on making the decision to have wls. I think you have to look back at your dieting attempts to help you make your decision. What I mean by that is are you a volume eater?, or do you eat out of emotion, boredom etc. When you cut back on calories did the weight fall off easy, or did your body fight you pound for pound.

I choose the sleeve, my restriction is pretty good & I fill up on less food. A restrictive only type of procedure has worked well for me, but some people need a little extra help, so they go the rny or ds route., which is a restrictive & malabsorption type of procedure.

You still have to diet & exercise, but surgery has given me a tool to help me take off & keep off the weight. I really didn't want my intestines rearranged & I didn't want a blind stomach that couldn't be scoped. I still like my sweets, but I know sometimes it's head hunger so I really have to be careful with that. I'm happy with my decision cuz this is a lifestyle that I can live with.

Each wls has its own pros & cons & you have to decide which one you can live with. You can eat around any wls, how successful you are depends on you. I wish you the best on your weight loss journey.

Thank you both for your replies. I have thought about the sleeve, but I really think I need the restrictive and malabsorption

aspects. Truthfully, I do deal with head hunger at times, but my biggest issue is skipping meals during the day and then eating 

way too much at night. I also have a mean addiction to soda. I'm trying hard to break this. I'm ready to make this change, and

 work hard to lose this weight. My gut says go with the DS because I think it will give me the best outcome. Even though I have

no doubt about having wls, I am a little scared and anxious. Thanks again for your replies.

Val pretty much covered it---with an EXPERIENCED surgeon, the risk factors and recovery time vary far more based on you as an individual. not which surgery type you choose. As for a BMI over 60---I know people who'd had a Ds with a BMI in the low 30s, simply because it was the best choice for their particular cir****tances. And isn't that what's it should ultimate be about/ The long term, not the momentary convenience?

I chose the DS because I knew I needed malabsorption, and I needed it FOREVER, not just for the 18-24 months you get with the RNY. (Both procedures cause permanent malabsorption of certain vitamins and minerals, but only the DS causes permanent malabsorption of a significant per centage of calories.) I also knew I would always need to be able to take NSAIDs, and I felt the DS was my best shot at avoiding the diabetes that runs in both sides of my family. An added benefit I didn't even think about at the time was the way it's cured my high cholesterol!

And I'll be honest---I wanted to be able to eat the foods I love. As a DSer, I eat a LOT of well-marbled meats, cheese, butter, seafood, nuts---things that are high in protein and in FAT. With my DS, I'm only absorbing about 20% of the fats I eat, and cholesterol stays around 100---not the 220+ it ran pre-op. The DS has 'cured' the guilt I used to feel when I ate this way, and that alone is worth a lot to me.

Yes, I do toss back a handful of pills four times day, but in return, I'm healthier than I've been since I was in my late teens---and I'll be 57 in less than a month. My immune system works so much better---I used to catch a cold in the fall and stay somewhat sin****il late spring. Not now!

I love my DS. Life is good.

Keep learning more.  The more you know, the more at ease you get.  If you've not found dsfacts.com, go look out there, and get yourself on the DS board.  We share a lot to fill in the gaps the surgeons and nutritionists lack.

Thank you MsBatt it helps to hear from others who have gone through it. Valerie G. I went to dsfacts.com and it was very informative. Thank you for providing that link. I will check out the DS forum on here as well. 

What the others have said about an experienced surgeon is true. Not all surgeons do DS, have you checked whether yours does or not? I had RNY and have been happy with everything so far. I wasn't that familiar with DS before my surgery, and didn't know of any surgeons in my area. I felt extremely well one week after surgery... but still had to have a daily nap for several weeks. I was able to go to support groups at the hospital and in the community before surgery which helped me see how my surgeon's patients were doing and what they thought of him. Good Luck with your decision.