40 BMI - should I consider DS?

Hi,

  I had a BMI of 41, no comorbidities, and a  first time surgery.  I am five years out in November and doing great.  I have never had any issues.  Good luck

The sleeve of the VSG, as many surgeons are doing it these days, it made smaller, meaning more narrow, than that of the DS. The reason for this is that with the standard 3-4 oz DS sized sleeve, the VSG people were experiencing significant weight regain starting at about 4-5 years out. So now they are being made narrower, which may or may not solve the weight regain problem, but definitely causes more problems with GERD.
     Many people with the DS need to take meds for acid reflux, but for almost all of us the meds control the issue nicely and that's the end of it. If a sleeve is too narrow, the meds won't do the job. And if it stretches out too much, you regain weight. There are a lot of happy folks in the VSG forum, but if you look closely, few, if any, are longterm post-ops. It will be interesting to see if they can sustain their weight loss longterm, or if this operation has built in obsolescence.

Larra

I qualified for the DS with a BMI of 37 and co-morbs.  When I actually had the surgery, my BMI was right at 40.  Your surgeon will likely recommend a longer common channel (125cm rather than 75cm) and that has worked wonderfully for me.  I'm 11 mos out now and down 105 lbs.  I'm 6 lbs away from goal.  I thought the longer common channel would make it so that I'd never lose, or not lose as much as the others on here, but I was wrong.  Of course, I think we all have felt that way in the beginning but this is truly the best WLS out there in my opinion!

This is all so helpful.  If I may ask, Darcy, what was your recovery like with the longer common channel?  And would the longer channel give you much less intestinal side effects (bloating, etc)?  Anyone else have a longer common channel -- and out of curiosity, what is the longest they can practically make it (eg, 150 cm)?  Anyone have reservations about a longer common channel for lower BMI patients? 

I exercise a lot (love cycling), but simply cannot lose any weight beyond where I am.  So combined with my relatively low BMI, I think I might need less of a heavy duty assist from the DS, given that the thinner I get, the more I will be able to ride (provided I wouldn't need to be near the bathroom all day).

Anything any of you could provide about what DS recovery was like for you would also be much appreciated.

Every surgeon seems to vary on their thinking about the common channel length.  SMO folks usually get the 75cm cc.  I got 125cm with Dr. Stewart, so he does adjust based on BMI and he will perform surgery on lightweights (not all surgeons will!).  I think I read one post where someone had a 150cm cc but I've only ever seen that once.  I'm not sure how many surgeons go that long.  Mainly I only hear of the 75 and 125.

As far as my recovery, I was back to work a week and a half after surgery.  It really depends on your job!  I am one of those with a high pain threshhold so I was off all pain and nausea meds a day before I left the hospital.  I remember having a lot of pain and nausea coming off anesthesia but my nurse was right there on it and I think that's the key to a good recovery, good pain management in those first 24 hours or so.  I went home on day 3 and it really felt as if I'd done 2000 situps.  Abdominal muscle pain was really it for me.  I have a desk job so I figured that if I could lay around at home, I could sit at my desk and focus on other things so I did!  I did have some nausea between mos 1 and 2 but opted not to take meds for it.  They can make you wonky and I was working so I just worked through it.  It wasn't bad and the acid-reducer really helped.  All in all, I felt tired and crappy for about 2 mos but it was liveable.  I was only really "in pain" for the first 24 hours.  I think having my gall bladder removed was worse than having the DS!

If you are an avid exerciser, you will want to really mind your protein.  The typical intake is 100 g per day but if you exercise you will want to increase that, maybe double it if you can.  You will feel more tired when you exercise and you do lose muscle mass with the malabsorption so keeping up with your protein is paramount.

Hope this helps!

When the labratdata site was still functioning, I discovered that Majormom and I had the two lowest BMI's recorded there. Mine was 35.2 when I signed into the surgeon's office and a whopping 34.9 the day OF surgery.

There are SEVERAL lightweights who have had the DS. I'm one, my husband had the DS and his BMI was a 38 (I think, or maybe 39).

I fought for the DS because I wanted to maximize my chances of having my diabetes go in remission and NOT deal with reactive hypoglycemia as a result of WLS, I already have RH and it's not fun. I also needed to be able to take NSAIDs. For articles on RH and the RNY, see my blog, dates May 20th and 26th. Click on my user name to go to the blog.

My husband and I have the same size sleeve portion but his common channel is 125, mine is 175.

And I reached my goal weight in 8 months and two days from the day of my surgery. My goal was 135...now I have a new goal of 125.

Come visit the LW's board as well.

Liz

BMI of 39 on the day of my surgery. It was DS or nothing for me! I could not imagine dealing with dumping my entire life, or having to chew everything to mush, or dealing with regain after going through so much to lose the weight. I also needed a more permanent solution to type 2 diabetes than the RNY offered. 

 I am also very athletic ( Martial arts, running, jazzercise, etc) , and while I did struggle a bit with protein levels the first year or so, I got a handle on it early, it is completely manageable. You couldn't have given me an RNY if you paid me, I wanted my pyloric valve, and to NOT regain! I may have considered a VSG if I absolutely couldn't have had a DS.

I studied the RNY for 14 years, not knowing that the DS was an option. I had sleep apnea, high blood pressure, diabetes, pcos and degeneritive disc disease in my spine. I was a walking time bomb, and needed WLS badly. I refused to get the RNY because I knew it would ultimately fail me. I had to find a permanent solution for my weight - not a temporary fix.

I'm so thankful I waited. I can't imagine life any other way. Think twice -- cut once. I know you won't regret the DS!!!

 Wow I had no idea that is why I gained after RNY. Back in 2004 my doc didn't even mention anything besides RNY or lap band and he said I was too heavy for the lap band. I guess I am lucky then most bc I managed to keep my weight off for a good 3-4 years but after I was prescribed remeron for insomnia the weight just kept piling on. This also explains why no matter how much I take my iron pills my laps always come back as I am slghtly anemic (confirmed this this morning after my 2nd ER visit in 2 days for a rash that won't go away). And it is not like I didn't do my research but back when I had my surgery done no one was pushing DS or even saying anything about it. When did these doctors realize RNY would only really work for 18 months? And if this is the case why are they still pushing it on patients? Isn't this unethical? I felt like a failure and I had my fertility doctor keep telling me I had the tool there should not be a reason I couldn't lose at least 80 lbs again. I should direct her to this website and she will see why I am packing on the weight. I swear I learn something new everyday. Thank you for the information. 

I was 39 bmi, no comorbids. My dad was much heavier and had a successful DS 4 1/2 years ago. My mom is obese. I am one week out of DS surgery and feel really great. I had the surgery because I was headed to a very unhealthy place. II researched ALL the different surgery/nonsurgery options. None had the long term results that matched DS. Once you decide on the DS, check around for surgeons in your area and sites like this and you will be amazed at how much info is available, and you can find specific info about a doctor. As fas as determining how much of the small intestine gets removed: It is on a patient by patient basis, but my dad and I laugh.... The doc told my dad that he always looks at people and starts calculating in his head, how much of the small intestine he would keep, if he was to perform surgery! People on the street...not just patients! Best of luck to you!