Paying it forward.....or not?

This is a tough one, but the good news is that it isn't your decision what wls she will have, if any. Just stick to the facts, those being that there is more than one wls being done, that they have different levels of success, that each one has different requirements for both success and maintaining good health, that there are responsibilities and expenses and follow-up involved, etc.
      Keep in mind also that being on Medicaid may severely limit her choices both for surgeons and for types of surgery. And also that the number of MO and SMO people who have a history of sexual abuse and/or other childhood or even adulthood trauma is higher than you might think, and many of these people do well with wls - though she might also benefit greatly from therapy both before and after any wls.
     She approached you for a reason, that being that she has seen your amazing success, and also of course that she sees you as an approachable person. I think telling her what operation YOU chose and why is legitimate, but with the added understanding of what the DS involves, an understanding that YOU had going into your surgery and that every potential wls patient should have for whatever operation they end up with.  If you can get across to her that different operations have different results, that lifelong follow-up is needed, and that at her weight some options (I'm thinking lap band) would be useless, you've done well.

Larra
     

 Thank you Larra, for your response.   I know my surgeon's office does accept some forms of Medicaid, but I don't know what kind she has.    I figure the best thing to do is to help her steer HERSELF in the right direction.  I plan to provide her with my experience, and give her the info about sites such as this, DS Facts, etc., and let her take responsibility for the rest.    

I too am a victim of childhood sexual abuse, and I'm sure it contributed mightily to my obesity.    It took me until my mid thirties to acquire a peaceful pespective on it, and to stop attributing its trauma to why I had challenges and stumbling blocks occur in my life.   That subsequent step was one of the most liberating experiences of my life.   

As a preop I think the best way you could pay it forward is to sit down with her and give her as much information as you can.  Knowledge is the key.  I know when I first learned about supplements and lab work I backed off of the DS a bit.  I needed to do more research and really think it through first.  

I'm also going to speak from a Medicaid, Welfare Single mom point.  I am on Medicaid, up until just a few years ago I was that single mom who struggled and received assistance.  And honestly I still would have WLS if I was where I was a few years ago.  Maybe not the DS but I still would of had some form of WLS.  For years I had researched the bypass.  That's what I originally came to this site for.  I still struggle financially but I have put my WLS surgery first.  I have enough vitamins (following vitaladys schedule) to last me at least 6 months.  I have a savings account set up for the "Emergencies" I can expect to encounter.  Yet I receive assistance, I receive cash benefits, food stamps and rental assistance.  My DP has schizophrenia and its hard for me to work because she needs a constant presence in the house.  Once I'm a few months out our goal is to get a nurse for her so that I can go to work.  There is assistance for vitamins (I was just about to post about this).  And the DS might be the surgery she ultimately needs at her high BMI I believe at this point something is probably better than nothing. 

I totally get where your coming from too.  When I went to one of my support groups I ran into a long time friend.  I hesitate to say friend because I tend to be a little snobbish in the intellectual department.  I've always just humored her and put her off while still trying to be nice because I might be a ***** but I am human.  So when I ran into her we talked about the surgeries, she's looking into the RNY and has actually gotten quite far with it.  She's on her last leg of insurance approval and honestly I'm SHOCKED .  She always looks dirty, I've had to give her food on occasion because she couldn't afford to eat, all of her kids have been removed from her care because she can't take care of them and couldn't stay sober enough (drinking) while she was pregnant with one of them and now he has FAS.  When I ran into her again at the laundromat we spoke again about it.  It's really bothering me.  She does not have a high BMI (possibly a 40 to 42) so I can't say its an extreme measure, she also has no other health effects from her weight.  She's not very intellectually there.  I'm really worried about her so lately I've been calling her more and checking in on her to see what her status is because it's obvious she's lacking a lot of information.  But I don't want to put my 2 cents in where it doesn't belong KWIM?  I mean she did make it this far right?  I keep trying to tell myself it's none of my business but I can't help but feel like her health is ultimately in danger. 

 I have already gleaned your posts, that you are not the stereotypical "Medicaid, Welfare Single Parent" kinda gal.    Your posts are well-written, insightful, and intelligent, and your desire to go out and make this work for you is very evident.    This young lady seems to fall more into the category of your support group friend, although I don't think she's a substance abuser.     Thanks for sharing your unique perspective with me.

I'm relieved that there is assistance for vitamins - this was one of my chief worries!

Thank you, I appreciate the insight :)

Check out my post about the Recover Program, it's not everything I thought it would be. The vitamin assisctance is not geared for the DS.  So even though theres assistance it's not what it could be.

She's lucky to have you in her corner, Julie! As mentioned above, I would probably, if anything, help guide her to a bariatric surgeon who takes Medicaid (hopefully he also does all 4 surgeries), and let the doctor assess the situation. As big as she is, DS sounds like the best choice, but if she couldn't handle the responsibility, then VSG would help her lose at least some weight and keep her options open for down the road for a DS. Good luck, and God bless you for wanting to help! Karen

Hijack---I giggle every time I see that cow leaping with the dolphin.

Julie,

You have already gotten some great feedback already so I have nothing to add there.

I agree with your concern about this person. I think that sharing your personal experiences and your story is a good. I also think that emphasizing that weight loss surgery is not a "magic bullet".

My 2 cents worth.

Tough, for sure. Simple or not, though, people tend to realize their own limits. I would just be very blunt with her--this is a serious procedure with lots of long-term consequences. Ask if she thinks she can afford protein and vitamins--possibly into the $100-$200/month? Can she be sure she'll have medical coverage to get labs done regularly? Can she take care of the kids AND herself?

A VSG is certainly unlikely to produce anything approaching 100% EWL, but it also would be much easier for her to manage. Even if it gives her 50% EWL, she'd have a better life...and maybe if she grows as a person she could revise to a DS someday.

I was thinking the same thing, Chad. That maybe she could do the VSG first, and who knows...she might just have good enough results that will increase her quality of life, and possibly get enough weight off to be able to have the GYN surgery. 
If she wants to do the DS part later if she doesn't lose enough, then that will be a possibility. She will already have been in the "wls" mode once and might better realize what would be ahead of her with the DS at that point. If she does the band (hope not!) or the rny it might be harder to revise to the DS as so many people on here know. 
And with her bmi so high if she were to do the DS, her surgeon might just recommend a 2 part anyway.

I think opening your heart to this woman, Julie, is a wonderful thing. Letting her know about your decision process and showing her how to get onto DSfacts and on here to learn about ALL procedures is a great idea. Also letting her know what all it takes to live the DS life will be helpful too.
Lisa