One-Stage DS with BMI over 90?

My BMI is 94. I've recently been told by the only vetted surgeon in my country that while he would do the DS in one stage "if [my] BMI was like 54 or something," with a BMI of 94 he's going to require me to do it in two. I know someone who also was required to do hers in two stages because her BMI is so high (different surgeon) so I know it's not unheard of. I just wanted to know how common it is among those with some of the highest BMIs. Because of my age and the timing of having kids, I'm looking at probably 3+ years between VSG and DS, and I honestly am reallly disappointed. 

I mean, it's one thing to be too fat for airplane seats, or too fat for buying clothes in a brick and mortar store, but now I'm too fat for WEIGHT LOSS SURGERY that's actually MEANT for the heaviest patients? Trying to wrap my brain around that is just... ugh. :(

Thank you so much for responding, Dr. Ungson. I actually feel better knowing that you, too, feel it's the correct way to go. I really appreciate your response. 

You CAN do this! Your life absolutely depends on it! I know you want to do it for your children. Every time you get sad, hungry, depressed and frustrated...just think of them. That's what I do and it helps a lot. I will pray for you and wish you the best wishes possible!

Rgds,

Robert

I don't have children yet, but I want them. Thanks Robert. :)

I started my DS process at a BMI of 73 and the surgeon wouldn't consider a single stage until I got down around 63/64. 
Luckily for me I've always found it easy to get that first big push of weight loss on a diet but could never sustain it and 
would eventually regain to a higher point. 

I did get mine single stage but I wouldn't be upset over a 2 stage. Just get a firm number from the Doc about when they would
consider the 2nd stage and don't be misled by your losses from the VSG, DS is still the best bet to take it off and keep it off.

Good luck. I'm right with you about some things you understand about being overweight and some are just mystifying.

Pete

Thanks, Pete. :) Yeah, I don't anticipate losing more than 100 or 150 pounds on the sleeve - enough to possibly have kids (maybe) but not enough to get me down to anything close to approaching a healthy weight. I never want to be skinny - my goal weight is 250, actually - but small enough to get around and do what I need to do would be nice!

ok, you can do this, one step at a time,  you are probably around 600lbs,  your surgeon is looking out for your safety, just simple things like intubation, DVTs, so much more are significantly higher, the higher our bmi, just know it is for your safety.  If I had that bmi I would insist on it.  depending on what happens (children) 2-3 years later you can get the intestinal bypass portion of the DS, at that time, your sleeve could be optimized as it will have stretched out by then, and possibly resleeved if needed.  you should be able to get down to a safer weight for the surgeon to do stage 2 of DS.  you have taken this step, I am so glad you are not getting a RNY, good for you, don't be disappointed, you really didn't gain this weight in 2 years, it will take you longer than 2 years to take off 400+ lbs.....hang in there, you are doing a great thing for yourself

I started out around 600 and have made it down to 525 on my own (actually, I went from ~600 to 525 in just a few months from moving to a new country and a new way of eating), but my weight has stalled. I'm a shorty, though, so I still have a BMI of 94. Thanks for your comments. I agree. :)

I haven't posted anything on here for several years but I really want to respond to your post.

When I went in for my consultation, my BMI was 57. My surgeon at UCSF in San Francisco said it was too risky to do the RNY because my liver was huge and would be in the way, he didn't want to take the chance of having to switch to an open procedure. We agreed the Sleeve would be the way to go and we could do a part 2 after I lost more weight and if necessary. I did very well and lost about 90 lbs.(not to my goal). I started to regain weight about 2 years after my surgery, slower and not as much had I not had the Sleeve. My surgeon had left UCSF so I saw another one that had been there for quite some time. He told me there was no way my previous surgeon would have told me there would be a part 2. I told him that was the plan. Funny because it's in my records, my primary care doctor is aware of this too. That totally turned me off to UCSF and left me feeling totally frustrated and like this was a hopeless situation. I went in for a routine endoscopy and my gastroenterologist encouraged me to pursue consulting a surgeon elsewhere. I finally did. I had a great consultation with Dr. Gregg Jossart. He agreed to do the surgery and was unsure at that time whether to do RNY or DS. Either one he said he would expect me to lose only 30 to 40 lbs because my sleeve had been done 5 years ago. While that was a bit discouraging, I did my research on the 2 surgeries and we met again. I went with the DS. I honestly think it saved my life. I have never felt so good and have never felt so "normal."  I began my journey at 311 lbs and am now 138 lbs for about the last year. My weigh may go up and down by about 4 lbs but I keep an eye on it. Dr. Jossart and I are thrilled because my weight loss exceeded both our expectations. 

I think the most important thing to understand for those considering weight loss surgery is to know that the surgery is a tool, an aid to help you lose weight. It is not a miracle way to keep weight off if you think it will do all the work for you. Research which tool may work the best for you and your lifestyle. Best of luck.