Should i do the DS

Hi there my name is Tracey and it has been awhile since i have been on this sight. Previously i posted somewhere on here and not sure if anyone will see my message. So i am asking for some advice again.

In August 2013 i had the GS. I started at 266 and then i did pretty well i thought and i got down to 214. That was by June 2014 and then I ended up having to have a hysterectomy. I have been struggling ever since. I currently gained back most of my loss i am back up to 236. I think my sleeve might still be working because i fill up quickly. Especially if i eat protein first. I have cravings for everything and i struggle all the time. Would i be a canidate for the DS or that new baloon thing they through an endiscope or should i get re sleeved. The down side is my insurance diesnt pay and it would be total out of pocket. Any advice would be greatly appreciated.

thanks

tracey

You posted on the main WLS board as well, so I'm going to reply here, too, just in case:

If you still get full easily, then your tool is still working. The problem isn't your surgery, it's what you're eating, and another surgery won't help you with that. You probably already know what you're doing wrong. The only way to get back on track is to go back to basics--weigh, measure, track--eat protein first, ditch the crappy carbs, and drink your minimum 64oz of fluid daily.

I also suggest checking into therapy to see why you continue to eat the wrong things even though you know you shouldn't.

Good luck!

Thank you Kathy

Tracey - you already got some good feedback from Cathy and I would second all of her recommendations. Like you said, you still have restriction from your sleeve but it's the cravings you struggle with. I agree that therapy may be a good option to help you understand the cravings and how to deal with team. Surgery won't help with cravings.

Once you've exhausted all other options and if you still feel you need to have another surgery, then the DS may be a good place to look. Please remember that the DS is a very dramatic surgery and requires a lifetime commitment to vitamins, labs, high protein, etc.

If you do end up looking at the DS as a viable option and the fact that you will be paying out of pocket, not sure if you realize the costs associated with the DS. The switch (you're already sleeved) is a complicated surgery and not every surgeon does the procedures (just because a surgeon can do the VSG doesn't mean they can do the DS).

Therapy couldn't hurt, but the truth is that you are far from alone. We are seeing more and more people with the sleeve start out well, as you did, only to find themselves struggling and regaining after a few years. While there are some people who continue to do well, there are many who don't, so while you could certainly work on your food choices, this is an operation that fails for many people.

I would not even consider the balloon. It's just another form of restriction, and a temporary one at that. It is supposed to stay in for 6 months, max. You sleeve worked longer than that and from what you say is still working to some extent, so what is a few months going to do for you?

The DS includes the sleeve you already have, and adds significant malabsorption and also metabolic changes to help you for the long haul. Given that MO is a chronic disease, we need something that works long term, not just short term. The DS has the best statistics of any bariatric surgery not only for percentage excess weight loss, but more importantly for maintenance of that weight loss, as well as for permanent resolution of almost all comorbidities. Yes, it's a serious surgery and requires a lifetime commitment to protein, and to a lot of vitamin and mineral supplementation. Anyone who isn't ready to make that lifetime commitment should not have the DS or any other bariatric surgery that includes malabsorption.

Given that you are self pay, IMHO it only makes sense to do something that will work long term so that you aren't back in a couple years (or sooner) wondering how you are going to pay for the next attempt. A lot of people who must self pay for their DS, whether revision from sleeve or the whole thing at once, go to Dr. Esquerra in Mexico. I know Mexico sounds scary, but both he and his hospital have received a lot of positive feedback. I will send you more info in a pm.

Larra

Strip off all the hype, and the sleeve is just another diet with a smaller stomach. A lot of people who had the sleeve do have regain or never lose enough. It's the 2010 version of the crap band. It will work for some but not most. If diets work for you, you wouldn't be here. You would be thin. And when these restrictive only procedures fail, the docs are all in the clear because they blame it on the patient. And we accept the blame because that's all we have ever known when it comes to weight loss. One failed attempt after another.

Sweet deal for the docs. And they keep on doing this KNOWING the patient will take the blame. And KNOWING the chances for long term success are limited. I think this is cruel.

Forget the balloon thing. It just adds restriction. Go see Esquerra/Wilhelmy in MX and get the switch. The DS is not perfect but it's the only procedure that works long term for most people most of the time. The combination of restriction and malabsorbtion almost always works. Yeah, I know the RNY has some malabsorbtion but the body adapts over time and around the 2 year mark, many start the regain. The DS has so much more malabsorbtion that the body can never fully compensate. And that's why it works!

Thank you for your frankness. When you spell out like that.....I see your point. its a great defense....

Tracey

Definitely check out Dr. Esquerra at Mexicali Bariatric Center for a self-pay revision from VSG to the standard of care DS. He's the best in Mexico!

Don't beat yourself up. We have a lot of sleeve revisions to the DS, and no, it's not all your fault. Some of us just need more than to eat less, and some of us are lucky enough to recognize that early that got the DS from the beginning. I could diet like a champ and was even atheletic, but never lost more than 20 lbs and it took a year and a half to accomplish that.

I think you have a lot of good feedback here. I especially agree with Larra (as usual).

I'm going to be frank...if you could have lost the weight (and kept it off) on your own you probably would have by now. The sleeve can help, but the compulsive overeating mind can easily defeat it by grazing behavior. The disease wants you fat. And it is much ore powerful than most people give it credit for.

With the DS, you WILL lose more weight, even if you eat crap. You won't lose as much as you could, but you will lose a lot more than the sleeve alone.

There are pros and cons to the DS. Being obese is so debilitating and humiliating that most people (including me) conclude the trade offs are worth it, but that is only for YOU to decide.

The sleeve has relatively few side effects since digestion is not altered.

The DS will increase your odds of kidney stones, intestinal blockages and osteoporosis. From what I've read (and experienced) the osteo is almost inevitable, with the other ones, the odds are increased but still in you favor.

There are treatments for all of the above, some better than others.

In addition, of course, you should be a proactive, not afraid to question doctors, researcher type. You will spend countless hours on the internet!

Mexicali is the place to go. About $12K from what I've heard, about the price of a decent used car. I'm sure once you're normal weight you will feel it was well worth it.

The feeling of being normal is priceless. And the improvements to your health undeniable. There are a few downsides, but for me, so far, they've been worth it.

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