Had my first appt.
Had my 1st apt. Dr. Oakley explained everything I needed. He even had the dietation squeeze me in to see her within 5 min just so I could get home that day (7 hr drive) My Psych apt is Tuesday. So then it's just getting approved. I am leaning towards RNY but if I can't loose 34 lbs. in about 2 months I'll have to do DS. I've lost 12 before the appointment so I'm hopefull. Wish me luck.
No I haven't heard anything yet! 
Yay for you, taking the first step! It is well worth all the hoops you have to jump through.
I'm wishing you luck in losing the 34 lbs. You can do it!!
From my experience the psych appt was a joke, he asked us a series of questions like how long have you been obese, who is your support system, have you researced weight loss surgery. maybe eight to ten questions all together. the whole thing took less than two minutes.
Good Luck and keep us posted!
Diane
Thanks for the information on the Psych questions. I can answer those easy. Appoitment is on Tuesday then i have to call the office and let them know I did it. Hopefully they can get the approval quick. I am dealing with State medicaid so you never know when they will close my case. Just extra things to stress about. My surgery cordinator thinks i can have the surgery in about 2 months. I want it early enough to enjoy a little Thanksgiving and Christmas. Early summer sounds great. Thanks for your help. Lisa
I just wanted to check this forum out b/c I'm pretty darn close to qualifying. I decided on WLS about 6 months ago & am getting the DS in 2 weeks (SUPER excited!). When I first decided on WLS, I thought I would get the band b/c it's safest & least invasive. The surgeon at the informational meeting told us that the long-term stats (5, 7 years out) were really bad with high failure rates, only maintaining like 20% loss of excess body weight, & a recent study that showed a 33% cummulative reoperation rate at 7 years out due to all kinds of reasons. Those reasons spurred that bariatric program to discourage the band & encourage the RNY. That led me to start actually reading research on it & here's how I came to decide on the DS . . .
I think that there are definitely people who are successful with thhe RNY, but the long-term stats are better for the DS, especially once you get into the 5-10 year post-op range. At 10 years post-op, 20% of those who had an RNY have regained at least 50% of their excess weight that they had either never lost to begin with or had lost & then regained. Only 5% of those who got a DS have regained at least 50% of the weight (or never lost it - HIGHLY unusual) by 10 years post-op. The main reason for this is that the RNY has A LOT of restriction due to the pouch size & regulating stoma and it has some malabsorption. Over time, it is expected that the pouch will stretch out some & that puts more of the responsibility of regulating food intake on the person, hence they fall back to dieting. I'm really successful at dieting & always gain the weight back. I do have instances where I eat way too much food in one sitting. I know I do & I also think that most obese people fall into that category/habit. Why the DS works better for long-term success for the average person is because it has some restriction (3/4 of stomach is removed), but it has A LOT of malabsorption. Fat is absorbed at 20%, protein at 40%, complex carbs at 60%, & simple carbs/sugars at 100% - so you still can't eat sugary crap all day long & expect to lose. You'll lose some, but not that much, if you eat sugary crap all day. However, due to the high malabsorption feature, that is why the long-term stats are better b/c that doesn't change, unlike the RNY's pouch expanding. I also like the fact that you can eat more. There seems to be a good bit of variability by patient for this, some people can eat a lot 3-5 years out of surgery & others typically eat like a normal 2000 calorie per day person - neither of whom tend to gain weight. There are exceptions, but it's very rare & difficult to mess up with the DS - I LOVE that. I would feel devastated having lost all of this weight & then regain it back. Horrible, unacceptable.
The 1/4 of stomach that is left with a DS (sleeve) also stretches some with time - this just is a normal process. At least the stretchiest part of the stomach is the outer curvature, which is the part that is removed, so it doesn't stretch quite as much. The hunger hormone ghrelin is also mainly produced in the portion that is removed. I understand that ghrelin production decreases with RNY patients b/c the stomach isn't being used, but some is still produced by the stomach b/c the stomach's still there.
One huge advantage of the DS is that all of the food intake & outtake regulating portions of the stomach are left intact, specifically the pylorus valve is left intact, which is removed with the RNY. Because this valve is remvoed, food passes in an uncontrolled fashion out of the pouch directly into the small intestines - that's what causes dumping symptoms in many of those who have the RNY. DS patients never - none of them - experience this, at all. This also means that you can take whatever medication you need to that has anti-inflammatories with NO risk of marginal ulcers b/c it's dissolved in your stomach before hitting your intestines b/c the pylorus valve still regulates food passage into the intestines. You CANNOT take NSAIDS prescription or OTC with the RNY!!! You risk stomach ulcers by doing so with the RNY.
The more I read, the more my reaction was, well holy **** why isn't this done more??? It's a very complex procedure & not that many surgeons know how to do it, so of course, if someone goes to the typical WLS surgeon, they're not going to coo about the positives of the DS when they can't do it! It would be like convincing their potential customer to go elsewhere. Sadly, I have heard of a # of surgeons who know about the DS purposely spread factually incorrect information, which I think is unethical, such as your body will literally smell or that you will poop 10-20 times per day - both are not supported by research or the many, many people on the DS boards. I've also heard the rumor that you need to wear a diaper - not true. Generally, people do have some awfully smelly farts & poop, but air freshener works. Aside from that, people on the DS board state that it's typically things that have white flour & processed sugar (not fruit) that causes gas, so people usually just avoid eating much of those things while out in public.
I think that there are definitely people who are successful with thhe RNY, but the long-term stats are better for the DS, especially once you get into the 5-10 year post-op range. At 10 years post-op, 20% of those who had an RNY have regained at least 50% of their excess weight that they had either never lost to begin with or had lost & then regained. Only 5% of those who got a DS have regained at least 50% of the weight (or never lost it - HIGHLY unusual) by 10 years post-op. The main reason for this is that the RNY has A LOT of restriction due to the pouch size & regulating stoma and it has some malabsorption. Over time, it is expected that the pouch will stretch out some & that puts more of the responsibility of regulating food intake on the person, hence they fall back to dieting. I'm really successful at dieting & always gain the weight back. I do have instances where I eat way too much food in one sitting. I know I do & I also think that most obese people fall into that category/habit. Why the DS works better for long-term success for the average person is because it has some restriction (3/4 of stomach is removed), but it has A LOT of malabsorption. Fat is absorbed at 20%, protein at 40%, complex carbs at 60%, & simple carbs/sugars at 100% - so you still can't eat sugary crap all day long & expect to lose. You'll lose some, but not that much, if you eat sugary crap all day. However, due to the high malabsorption feature, that is why the long-term stats are better b/c that doesn't change, unlike the RNY's pouch expanding. I also like the fact that you can eat more. There seems to be a good bit of variability by patient for this, some people can eat a lot 3-5 years out of surgery & others typically eat like a normal 2000 calorie per day person - neither of whom tend to gain weight. There are exceptions, but it's very rare & difficult to mess up with the DS - I LOVE that. I would feel devastated having lost all of this weight & then regain it back. Horrible, unacceptable.
The 1/4 of stomach that is left with a DS (sleeve) also stretches some with time - this just is a normal process. At least the stretchiest part of the stomach is the outer curvature, which is the part that is removed, so it doesn't stretch quite as much. The hunger hormone ghrelin is also mainly produced in the portion that is removed. I understand that ghrelin production decreases with RNY patients b/c the stomach isn't being used, but some is still produced by the stomach b/c the stomach's still there.
One huge advantage of the DS is that all of the food intake & outtake regulating portions of the stomach are left intact, specifically the pylorus valve is left intact, which is removed with the RNY. Because this valve is remvoed, food passes in an uncontrolled fashion out of the pouch directly into the small intestines - that's what causes dumping symptoms in many of those who have the RNY. DS patients never - none of them - experience this, at all. This also means that you can take whatever medication you need to that has anti-inflammatories with NO risk of marginal ulcers b/c it's dissolved in your stomach before hitting your intestines b/c the pylorus valve still regulates food passage into the intestines. You CANNOT take NSAIDS prescription or OTC with the RNY!!! You risk stomach ulcers by doing so with the RNY.
The more I read, the more my reaction was, well holy **** why isn't this done more??? It's a very complex procedure & not that many surgeons know how to do it, so of course, if someone goes to the typical WLS surgeon, they're not going to coo about the positives of the DS when they can't do it! It would be like convincing their potential customer to go elsewhere. Sadly, I have heard of a # of surgeons who know about the DS purposely spread factually incorrect information, which I think is unethical, such as your body will literally smell or that you will poop 10-20 times per day - both are not supported by research or the many, many people on the DS boards. I've also heard the rumor that you need to wear a diaper - not true. Generally, people do have some awfully smelly farts & poop, but air freshener works. Aside from that, people on the DS board state that it's typically things that have white flour & processed sugar (not fruit) that causes gas, so people usually just avoid eating much of those things while out in public.
HW / SW / CW / GW 299 / 287 / 160 / 140 Feb '09 / Mar '09 / Dec '13 /Aug '10
Appendicitis/Bowel Obstruction Surgery 8/21/10
Beat Hodgkin's Lymphoma! 7/15/2011 - 1/26/2012 
Ran Half-Marathon 10/14/2012
First Pregnancy, Due 8/12/14 I LOVE MY DS!!!
Ds is probably what I end up with. I would like the surgery as soon as I get approved. Don't really want to wait till I loose the 34 lbs. Also i take ALEEVE and have a history of peptic ulcers. This is just what he is opening the doors for medicaid to approve 1st I think. He said it can change to DS. Our worries are that I had 2 c-sections and am cut from belly button down and have lots of scar tissue. He didn't really want to open me and with me living 30 miles to the nearest clinic for wound care or 7 hours from my surgeon and not get the proper care. So I do have the option DS My BMI is 62. Thanks for your help 
Lisa
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