Well I got my referral from my Doctor!

Hello. I'm a newby to Obesity Help. Just had my routine doctors visit this past week and had gained 6 lbs. Doc was not happy and has given me a referral slip for bariatric surgery. I had looked into it several years ago but my insurance back then wouldn't cover it. So with my insurance now I am covered. So my journey begins. I would greatly appreciate any information that will help me in this journey. I am 5'3" and weight 383 lbs. Through my research I would like to get down to 130 lbs. that's a 233 lb drop. My BMI is 57.3. I am wondering if I can do this. I am setatary and don't move much due to fatigue, back and knee pain, I know I need this surgery. I want to walk again and move. I would love to go horseback riding again, do gardening, and wear normal clothes. I admit surgery scares me. Complications scare me.....

So where do I start from here.... I have a cardiologist appointment next month. I guess I need to send this referral slip into my insurance company or do I go the the local Bariatric office........ Please someone tell me where to start before I loose my nerve. I am leaning towards rny but friends advise me to go with the sleeve. The sleeve to me seems too easy to revert back to old habits. With the rny it seems to be a no turning back type of surgery. Decisions decisions!  I best get use to it and make the best ones I can. Will post again later. Thanks for listening! 

Your friends may have other things in mind as well, as you mention back and knee pain, which you may need to take NSAIDs for the pain at some point in your life, which you aren't ever supposed to again with gastric bypass (RNY). 

I love the sleeved stomach, but your BMI is high, and restriction alone may not be enough for you. There is another surgery called the DS (short for duodenal switch, not to be confused with mini-DS, SIPS or SADI) which you did't mention, and it has the sleeved stomach so you can take NSAIDs if necessary, but also has malabsorbtion similar to (but not the same as) RNY. The DS does not have the high rate of dumping syndrome or reactive hypoglycemia that RNY does. It also has the best statistics on weight loss, maintenance of that loss, and resolution of co-morbs for all BMIs, but especially for those over 50 bmi.

It takes more time and training for the surgeon, so many only do the RNY, and if you first go to a surgeon that does RNY, that is all that will be recommended. Sort of like going to the Kia dealer and asking for a Lexus. They won't sell or recommend that and lose a customer.

The drawback with the DS is that you MUST be proactive with taking and tracking vitamins (yes, you do with RNY as well, but you may have to take even more with the DS) and it's non-negotiable.

I have the DS, and am happy to help with questions that I can answer, or help guide you to medical studies or other information if you want. I'm 8 years out, and am thrilled with the loss of my weight and co-morbidities, and you may have noticed that you see some of my RNY or sleeved friends on the revisions and failed weight loss boards. No surgery is a guarantee, but the DS is the closest we have, so far.

I started at 420lbs. I decided on the sleeve for many reasons - the reality of weight loss surgery is that early out its pretty easy to lose weight regardless of the surgery type. Stats for WL of sleeve vs bypass are pretty close. Yea - bypass gives you the malabsorption component for a max of 18mo-2yrs. That's it. After that you end up with a restrictive only tool. For me the possible complications of the RNY weighed heavily against the small bonus.  I have several friends with both RNY and sleeve who have gained most of their weight back. Success depends on the person and habits they build and how well they deal with the WHY in terms of their eating. 

I didn't want to have surgery just to fail so preop I meet out to lose as much weight as possible to prove I could do it - I ended us losing 85 lbs before I had surgery. Plus I read during my research that people with a BMI 50+ are at greater risk for surgical complications, so I decided to push for a BMI under 50  I think my BMI was 49 at surgery time. 

I ended up losing a total of 232 lbs. now I didn't have huge success in keeping it off bc I never found the right tools to keep it off. I gained 90lbs from my lowest bc of SUGAR (which no surgery not even the DS would have helped with). I have been successful at losing 45 lbs of that regain at 5 years out because I did find the tools I needed.

I joined Overeaters anonymous and got the tools and direction and help I needed. That was the only thing that worked to help  me get the regain off. My only regret in this whole process has been ignoring OA for so long. 

If you want to chat about it, send me a PM - I'm willing to chat anytime about my experiences. 

The referral is for which ever doc you decide to go to, not the insurance company. Most Bariatric Surgeons have seminars. Call several local offices, say you would like to go to a seminar. They will probably ask you your insurance, to make sure they take it. You can go to more than one docs seminar, start there.

Congratulations on making the decision to have WLS!  I am about 5 years out, and have kept (most of) it off with a LOT of support and different tools.  I had the VSG and paid out of pocket, so I am not sure about the insurance portion of things.  

No matter how many stories I'd heard or how many people shared their journeys with me, I was still scared, and the encouragement helped make all the difference in the world. Fear of the unknown, fear of change, fear of failure, fear of loss of my relationship with food. It was a  relief to be able to come on here and know that I wasnt alone, and that other people had been where I was.  

If you can, start attending local WLS support groups now so you are not alone, use every resource that you have available - Feel the Fear and do it anyhow.  I dont know if you are like me - I dont like feeling vulnerable and exposed, but I needed this help and no one would know if I didnt step out.  I learned about  different tricks and tools, but also more about the psychological aspects and hormonal - things that could blindside you or derail you.   There are many people on here and in your area that are going through the same things that you are, and it really does make a difference.  

If you know that there are other issues that you need to look at, start looking at them and getting the help for them that you need now - a counselor, therapist, books, recordings, you tube - I've used them all lol!  I am an emotional eater and had to learn different methods to deal with whatever eating allowed me to ignore.  The weight loss may trigger other emotional things and if you have your supports and tools to help you in place, it will make it easier.   Good luck!

Congrats on making the choice to have wls. Just remember you can succeed or fail with any wls & all of them is pretty much a no turning back kinda thing. Research as much as possible, go to seminars, talk with other patients. Fear is natural, but if you educate yourself it might bring down the fear level a little bit. 

You'll have to take a hard look at yourself & your dieting habits to find the surgery you'll like & be able to live with. For some people a restriction alone type of procedure isn't enough & they needed the extra metabolic boost that the rny & ds gives. I also had a high bmi that was in the 50's but I still chose the sleeve & am happy with my choice. I've always lost weight when I restricted my calories, but for others it was a fight for every pound. For each wls there are pros & cons. Do you have gerd? VSG can make gerd worse & I'm guessing the DS will do the same thing since we both  have sleeved stomachs.

Good Luck in whatever you choose to do.

hello i used to be a newbie as well 16yrs ago:} i had the open rny and it gave my life back, i was on disability for 10+

yrs not due to my epilepsy but because of my mobility. so no matter which one you choose...do it for yourself and for 

your health. at that time i weighed 406 and lost 200 in my first yr; then i was covered to have my panni done which in total

my co-pays was 200.00. now if the insurance would've still covered the lower body lift and my arms i wouldn't be here trying to

have a revision done to the ds. yes i still watch all my vitamin intake; and my weight got back up to 326 and i'm hoping to get

it to at least 180 so when i'm able to get the excess skin removed it'll bring me even closer to 160. i don't know how long it'll take to get approved but hopefully i'll be back on here letting you all my surgery date:}