Well now I'm REALLY confused...to DS or not DS?

Oh crap, I'm sorry. I was posting while running on empty last night. Vitalady wore me plumb out with a thrift shop marathon :-p. I was thinking of Cirangle when I said that. I'll edit my post immediately.

Lori,

Go see Crookes and talk to him away from the seminar setting.  Unless you have a medical reason that the DS would be contraindicated there is no reason that you can't have it if you want it.

As you know, the DS takes a significant amount of lifetime care.  In the wrong (patient's) hands it is possible for complications to arise down the road.  Most DS surgeons see their patients for surgery and for a couple of years after that and then the patients tend to stop follow-up with the surgeon.  Without proper long-term care (and this isn't something most DS surgeon's truly provide) patients get into trouble and then a bad rap falls upon the DS.

If Crookes sees that you understand the proper care and handling of your DS he will do it on you.  At least this has always been the case with him.

There are lots of locals who still get their DS from him.  Sadly many of them are not on this board so we don't see a lot of it here.

Elizabeth- Can you elaborate?? He didn't talk about the sleeve at all either today. Just the RNY and the band.

Samaro- I will go see Dr. Crookes. I found him on dsfacts.com so I assume he's vetted for the DS. Anyone know otherwise???

If he were not already on the list, I would be voting NO right now.  With all due respect to Samaro, I've heard too much unpleasant information about how difficult and obstructively he and his office operate over the last several years.  I have stopped recommending him myself for the last several years, and I am going to recommend that Bev consider REMOVING him from the vetted list.

Something tells me he won't mind.  I don't know if it is because he can't stand up to the bully Katkhouda or what, but I think sending anyone to him when Keshishian is available locally now is pointless and inappropriate.

If Crookes wants to chime in on this conversation with an explanation, I'd be happy to hear from him.  Otherwise, my mind is made up about him.

My comment about the sleeve thing, as I just edited into my post, was a mistake. I was thinking of Cirangle. However, I'd listen to Diana if I were in your shoes.

Lori, Dr. Crookes is indeed one of the vetted DS surgeons.  We are very fortunate to have two good DS surgeons in Southern California and if somebody can't afford the additional $3,000 - $4,000 program fee (above insurance copays) that Dr. Keshishian requires then Dr. Crookes (with no program fee) is the go-to choice.

~S

Even in the "right" patient's hands,  significant problems can come up.  It is simply not possible to predict.

I hear this BS of it being too big of an operation all the time, this is just ignorance, I revised with a bmi in the low 30's, there is someone on this board that revised with a bmi of 19.  I don't know how long you had the band and if you have complications, but I will tell you if you had complications and your esophogus is damaged, RNY would be a waste of time, this is NOT to mention, I would not get RNY anyway.  DS is not mainstream, many are afraid of it, most due to ignorance, oh my gosh, you are going to die, your diarrhea will kill you, you can't keep up with all the vit/min deficiencies, you will get too thin-come on.  Stay away from RNY ESPECIALLY if you have had a band, cause sorry to say pretty much you would not lose well or keep it off, and with a BMI of 49, I think that is high for a revision patient anyway, what do you they want a bmi of 50, 60, 70?   You are not going to lose like a virgin DS.  complicated surgery and they can custom make your limbs, my cc is longer than the "average" 100cm, it was custom made for me and I didn't want that many more malabsorption issues.
The DS will give you an incredible quality of life, dont let them talk you into a RNY, oh my gosh.  having a band then revising to a DS it is completly different, for the pills stink, but I am never sick anymore (I was revised 9 months ago) going from being sick everyday all day.  bottom line the docs are sooooo cautious because of ignorance, they dont' know the DS, what to order, how to interpret the bood work, how to address the vit/min issues and think it is the older, no longer performed malabsorption surgery............  don't let them perform the RNY on you.....

 I agree with others, and I think some doctors shy away from the DS because they don't want to take responsibility for advising their patients to take mega doses of vitamins for the rest of their lives, nor do they want to have to follow them for the rest of their lives,  and surgeons have been GROSSLY underprescribing for years, seen medical issues with deficiencies crop up, and then say "Seee?   The DS is too much of a "big gun" surgery and we're having problems show up years later.   Yeah, because they're afraid, that with 100 k iu of D, their patients might go "toxic."   It just ****** me off to no end.     

I've been on these boards for a long time, and again, with all due respect to Samaro, I'm not terribly impressed with Crookes.   You have two of the best surgeons in the WORLD in your state - Rabkin and Keshesian.    They are the only two surgeons that I would trust MORE to do my DS than my own doctor.   I'd rather wait to see Keshesian than have Crookes do my DS.    

But let's also acknowledge that surgeons do not want to create practices which follow up and act as internists etc for patients for the rest of their lives.  They are surgeons,  they chose to be surgeons.  They did not choose to be bariatric maintenance doctors for the rest of their lives. 

And the non-compliance issue is huge....I mean huge.  I'm sure that many physicians have seen DS patients down the road with serious problems - osteoparosis,  severe chronic anemia,  serious protein malnutrition,  vitamin deficicies.....and many people cannot afford the treatments and specialists needed to deal with these things.  I am not at all surprised that some surgeons feel that the problems that may inevitably accompany the DS for many people are really not worth the weight loss in some cases.  Yes the weight will be gone and perhaps comorbidities (if there were any),  but the long term effects of the DS are very very serious.

And there are only a handful of DS surgeons who have serious followup in their practices and even fewer who have skilled and knowledgeable followup. 

The DS is really,  really not for everyone.

All this talk that the only reason surgeons shy away from the DS is just because of money is ridiculous.  There are just too many non-compliant patients (and even some compliant ones) that end up with major major problems.  I think in some cases it is the responsible thing to steer somebody away from the DS - it should be on a case by case basis, taking into consideration socioeconomic status,  finances,  the likelihood of never being without health insurance, intelligence, "competence" as its been called here by others,  psychological state,  ability to advocate for one's self and be assertive,  ability to understand a whole lot of sophisticated medical stuff....it is NOT just about high BMI and comorbidities and the best weight loss result...

I also think that the notion of a good surgeon not appearing on dsfacts.com (a list I read with a big grain of salt) because he may do it in 2 stages is absurd.  Perhaps those surgeons want to see how a patient complies and does with the VSG for a while before doing the part with much more serious implications.    There are many factors that should go into a surgeon's (and patient's) decision as to whether or not to do the DS.  It's easy for us to sit here on a website,  knowing only what people write here,  and say "oh the DS is for you"  but really,  who knows what the cir****tances are of somebody's life - the criteria I listed above - maybe a physician has good reason to discourage the DS,  or to insist on two parts. 

Much more to say on these issues,  I'm sure.  I'm also sure somebody will call me "anti-DS" which is also ridiculous.  But to be realistic is what is most important.  The DS is not a magic weight loss spell.  It is a very very serious decision with lifelong implications and requirements and it is NOT for everyone.