Im a Noob to WLS and I'm trying to decide the best way to go...here is my story.

     My name is Denis, I'm 41.  I began my weight loss journey roughly 2 years ago.  I had been struggling for nearly 10 years with my weight but made the decision to do something about it in 2013.  I started seeing a Dr. Singh when I was 596 pounds.  I had made the decision to try to lose the weight naturally, and Dr. Singh prescribed a diet called the Advanced Health Systems Diet from Robard.  it was essentially Protein Shakes, Protein Meals, and Bars.  I was supposed to eat these things 5 times a day and have either a 1 pound steak, 3 chicken cutlets, or 3 pork loin chops w/salad for dinner, and I was to drink 4 -18oz bottles of water a day.  I included in this Tuna Salad on romaine lettuce.  for 2 months I was very successful on this path losing from 596 down to 554 pounds.  but then Dr. Singh got married and ran off to Hawaii with her new husband...there was no longer a Doctor in my area that could provide these meals.  So my family and I noting the success had a discussion and figured Atkins wasn't that far off from what I had been eating so my wife, daughter and myself all started buying only the frozen meals and bars from Wal-Mart...and that's what we ate for about a month...during this time my daughter and I started going to the YMCA pool every other day where I would move in the water constantly for 45 minuets.  I enjoyed the exercise and felt I was doing well, until my entire family weighed ourselves and found that we had somehow gained weight using the Atkins meals...on closer inspection of their website...in small print we found where it stated not to eat more then 2 Atkins products a day as there were hidden alcohol sugars that are not declared in their nutritional blocks. 

     Around may 2013 I injured my right leg exiting the pool at the YMCA.  I went to the doctor and she told me to stay off the leg for a time and when I feel better go back to doing what I had been doing.  then disaster struck, my truck broke down (the only vehicle we had that I could fit in)...I spent the last part of 2013 and most of 2014 dealing with my leg pain, that eventually turned into a sciatic pain in my right leg...this led to a back problem that began to spasm forcing me to lay in the bed and elevate my legs in order to alleviate the issue.  I dealt with this during the summer of 2014 all the way until September when I had a major back spasm that sent me to the hospital by Ambulance.

     I was blessed by this hospital visit because it put me in touch with a social worker by the name of Tom who has helped me by juggling my doctors visits and arranging ambulance transport as I don't have a vehicle or way to get back and forth to the hospital.  I have had physical therapists and Occupational Therapists come to my house to help me adjust to my back issue while Tom has helped me make arrangements with my doctors.  due to the last year I have made the decision to move forward with bariatric surgery.  I am capable of walking again, I am still a bit sore but I'm willing to push myself.  I have been on a partial liquid diet...apparently my resting metabolism is 5100 calories a day...the annoying part is the dietician gave me a diet plan that falls far short of the amount of calories they want me to eat daily...I have been told they want me to take in 2300 calories a day.

     The biggest issue I have found is eating the amount of calories they want...so I have split my meals up to 6 times a day...I got lucky and found a great Protein shake called Premier Protein which has 30g Protein, 1g sugar 3 grams fiber and tastes like a Yoo-hoo.  I don't know if a lot of you know what a Yoo-hoo tastes like but its not half bad as long as its cold and you shake it up.  I have also been eating 1/2 cup low-fat cottage cheese mixed with 1/2 cup unsweetened  mixed canned fruit in water.  90 + 50 Calories a piece respectively.  for a lunch I eat 1 can of Solid White Albacore w/1TBS of Real Hellman's Mayo (Sorry I cant eat that lite crap), 2 Clausen pickle spears, .5 small onion, 6 leaves of Romaine Lettuce (I put the tuna on the lettuce) No bread at all.  Dinner can be an 18 oz. Rib eye, 3 chicken breasts, 3 pork loin chops, or fish depending on what I have in the house.  I can also make a taco salad without the tortilla's  ATM this is what I'm eating along with 4 -18oz bottles of water a day.  I cut out coffee, no sodas, no bread, no potato's, and no rice.  if I don't lose weight at the next weigh in I will be very discouraged.

    I supposedly have 2 more months before they schedule me for surgery, based on the math I should lose between 5-6 pounds a week, and that's assuming I am sedentary, which I am not, I have been up making my own meals, and exercising with my physical therapist  though I feel like I can eat less then 2300 calories as Doctor Singh had me eating 1875...but I'm following the Doctors instructions. I'm curious what would happen if I added CLA supplements to the mix.

     Ultimately I haven't decided if I want the Gastric Sleeve or the RNY...from what I read the Sleeve offers more normalcy long term, but I'm not sure if that's a good or a bad thing.  I have been watching a lot of episodes of my 600 pound life and I see the patients doing stupid things that inspire me to stick to my prescribed diet and listen to the doctor and dietician.  the reason I am posting here is that it was required of me to participate in online discussions so here I am.

I also have a person that requires me to participate on this online discussion and that person is-----   ME!!!  ha ha :)   In addition, I belong to a monthly WLS support group located near my home.  I log on to the OH website between two and three times a day, sometimes in the middle of the night for support, wisdom, and advice.  I am certain this helps me stay on track, do the right things, eat the right way, and continue to enjoy life thinner, healthier, and happier.      

I appreciate the sentiment Selhard, but as a guy I'm not to big on opening up to the world concerning my personal struggles.  I also don't have transportation to get to and from a group setting so I have to use online as my support group.  I have the willpower to make this work, and recently I have found the motivation with the combination of ending up permanently laying in bed and watching my wife work like a dog to support the family, and take care of me...I found myself faced with my own mortality.  I have had to question myself as a man, who I truly want to be the rest of my life...a 600 pound invalid relying on everyone around me to make me comfortable until I die...or an inspiration to my 19yo daughter, and 42yo wife who lost the weight and went back to work to prove I truly love them both and would do anything for them, even sacrifice my comfort for the status quo.

dkorb - opening up about heath and weight issues is hard, even for us chatty women. Sometimes I can't stop crying when I share honestly, because the whole stinkin' mess causes pain - both physical and psychological.

You did a great job sharing, especially for a guy.  (kidding)  This BMI > 50 board is a great bunch of people. We understand the major challenges that lightweights don't get.

Congratulations on your loss so far! Keep at it.

Great job, indeed.  Receiving an immense amount of help and support makes a difference.  I've lost 200# of "protection" but gained a better life.  Never give up.

At your size, you need to research the DS. It has the best stats for weight loss, maintenance of that loss, and resolution of co-morbidities especially type 2 diabetes and high cholesterol. 

I do happen to like the sleeve (which the DS has as well - KEEP YOUR OWN PYLORIC VALVE!!!!) but not for someone your size. There are lots of studies you can access the abstracts for free at dsfacts.com. 

I have looked at the DS and the Idea of rerouting and then cutting out a huge section of intestines disturbs me.  I know myself well enough to know that once this weight is gone, its gone...I will never allow myself to be trapped in my house again.  I was always very active when I was young, and I am former military, the reason I gained the weight was a combination of a lack of sleep and overwork with no time to take care of myself...I was working 16 hour days, not eating breakfast and sometimes lunch and having excessive dinners...and I was eating large amounts of simple carbs.  The reason I have kept the weight on so long isn't a lack of not trying to lose the weight.  It has been a combination of injury, motivation and lack of finances.  After being confined to my bed for almost 6 months due to a back injury, barely able to make it to the bathroom, and watching how it affected my wife and family, I found my motivation and finally got the help.  ATM I don't care if I ever eat fast food again, I like my high protein diet and I haven't even gotten the weight loss surgery yet, its still another 2-2.5 months out, and I suspect I will drop 50 pounds before surgery...I began my journey at 596 according to my home scale, now it says 548 as of 2 days ago though my doctors scale said 566 around 2 weeks ago so I'm not sure if my scale is off or not.  So I am posting my doctors weigh in's here.  My heart is set on the gastric sleeve or the RnY.  I'm positive that if I continue this weight loss and get to around 300-350, I will start going to the gym on a regular basis...my personal Goal is 250 by Christmas 2015.  Let me emphasize, I am eating Zero simple carbs...No Milk...No caffeine...and believe it or not I'm happy.

I'm not sure it matters, but they don't remove any intestines with the DS, just part of your stomach. It will be the same as the sleeve. The intestines are just rerouted. I used to fret about having some of my stomach permanently removed, but I was and idiot. That rubbery fundis that allowed my stomach to stretch to the size of a football and all it's extra ghrelin (hunger hormone) production - good riddance to it! I also don't see any benefit to the RNY over the DS, but see several advantages of the DS over the RNY. I've seen you on other boards now and know you are researching, but I'm happy to help you dig up any info you may not be able to find. Dumping is sold by some as a "bonus" of RNY, but there is zero data showing that dumping helps with weight loss or maintenance whatsoever, and dumpers are just are occasionally miserable from it. Also read up on reactive hypoglycemia, as that seems to be very common as RNYers get a few years out.

I guess I'll point out one other thing, as it's not always mentioned as prominently on these boards, but I have/had something called PCOS (which of course you can't have, as a guy) but it's linked to metabolic disorders. Sure, you had extenuating factors contributing to your weight gain, but it's hard to get that heavy and not have some metabolic issues going on. There is some data about the DS and that it better addresses metabolic issues than the other surgeries, but that may be something you want to read up on. I think I saw a comment by you that you read something on the dsfacts page, so I'm pretty sure you can find that data there too.

I should have been more specific in my description, I meant how they remove the section of intestine, attaching it further down leaving it to dangle.  However after reading and listening for a bit, I am coming around to the Idea of the DS especially after the suggestion of Lara from DSfacts pointing me to the OH Revision forums....16 members for 598 pages leaves quite an impression.

"16 members for 598 pages"?? 

I think maybe you just looked at the FIRST 16 people who have posted on that forum in the past year?  There are actually 25 pages of 16 people per page who have posted on that forum in the last year.

Also, note that the majority of posts there are about revisions from band to VSG or RNY.

Before you make your decision, be sure you know the pros and cons of each, what the potential complications (both short term and long term) are for each surgery.  Whichever surgery you select, be sure that you are willing to endure whatever the worst possible side effect/complication is from the surgery you select.

Lora