WLS's candidates, failures - revisions - Why do you do this to yourselves?
I’m just like some of you you. Really. Just over 6 years post-op from WLS. A duodenal switch (DS) which has truly been a gift from the gods. Like so many of you, I researched my options and really didn’t like very much of what I saw starting some 15 years ago in the options available. The DS was still somewhat in it’s infancy and I wanted more back than even though it was being performed some 5 or 6 years prior with preliminary very promising results.
Ok, so I was gifted with a medical background that allowed me to sift through some of what was the wheat from the chaff from the medical literature back then, and perhaps even more so now with my increased interest and research to date. Hardly makes me even remotely an expert, but it seems to me even the most average intellects prosecuting the most basic inquiry into morbid obesity and the surgical intervention solution sets as this simpleton learned could have come to the same conclusions. Sadly, from the posts here and all over the various boards over the years, I’m NOT seeing the enlightenment that should by now be forthcoming. 15 years ago we were not all on the net, but now that most of us are, I’m left wondering even more, “Why?" My bias is clearly more with science. Anecdotal evidence can be helpful, but it has limited utility. So much of OH posts are oriented toward the recent anecdotally proffers, and that’s perfectly fine and expected in the short-term for those having WLS. But with all the vast informational data available, I have to get back to my basic question? Why do you do this to yourselves? By that I mean have you learned anything from being morbidly obese and the challenges to this therein?
What seemed painfully obvious to me from the beginning and why not you folks?
2. Most of us who find ourselves morbidly obese are METABOLICALLY CHALLENGED. Translation- It’s not your fault. The DS is really the only WLS intervention that addresses this quite appreciably well. So well in fact, that we can live and and eat normally without appreciable regain out long-term. Put simply, we DS Post-Ops have the very best Stats. overall for maximum excess weight loss and KEEPING it off out long-term. Not to mention the permanent resolution of comorbities, especially type 2 diabetes.
3. But no, I must be, or you’re more certainly wrong. IT IS MY FAULT! I made the wrong choices in my eating habits. Therefore, I deserve to be punished for my gluttony sins and that is singularly the reason
~ I found myself morbidly, or super morbidly obese! So, I will get my TOOL- lose weight and then no matter what, I can or will find success. Why, because all I need is a tool and damn it, I have dieted successfully in the past to wit, I got some of the weight off. Short-sighted? Do I really need to answer that?
Look, people, fat or thin we could all stand to make better choices in food consumption in the most general sense. But, should that translate in a LIFETIME of PUNISHMENT though risking your very life for WLS to do what? A regiment of more Self-Punishment at just MORE DIETING for the rest of your life? Not only more dieting, but more restrictive dieting than you have likely ever done in the past. How has dieting in the long-term worked so far? Oh, but now you have a F**ning tool... PLEASE. Just look at the posts here and elsewhere on the boards. Revision and failed WLS boards are one thing, but one only needs to look on the main OH board to see the perioperative misery and certainly that which can be seen out long term. MORE and MORE self-PUNISHMENT, meaning it’s ALL my fault! God help me because I can’t depend on this sometimes medieval dumping syndrome to control cravings? What the hell is so bad at wanting to live a normal life eating like a normally thin person does? I eat normally and drink with my meals with a few simple rules of protein and supplements first, and the rest can be gravy, often literally? Never mind, this notion one is desperate to just get he weight off and don’t what to bother appealing my rights for the WLS surgery that is best for me. I’ll worry about the dieting for life thing later after I get my TOOL and any appreciable regain, I might face is a matter for another day. Assuming- this is even disclosed adequately from the surgical practice or from one’s own in adequate research.
4.“But, but ...-my consulting PCP and Surgeon really knows what’s best for me, and this is what my insurance says they will approve." Why would I question their expertise? Here’s a clue people. Surgery is “often" largely a technical skill. Bariatric surgery is dead simple on the whole to learn for those most commonly done in this country and elsewhere. The Duodenal Switch, is MUCH more technically difficult to learn and master well as a procedure. Takes longer to perform under the knife, and sadly, insurance remuneration of such skill and said procedure is LESS for both the practitioner and hospital, ect in contrast to those more commonly performed. [I]n contrast, virtually all the other WLS interventions are a snap to learn and do with some degree of proficiency. Not all, but many, if not most Bariatric surgeons having developed a taste for surgery- demonstrate marginal promise early on in a general surgery rotation looking for a lucrative practice. Easily learned, these very often marginalized skilled challenged newbie's would be fools to pass up on this increasing low skill level financially rewarding burgeoning opportunity. And trust me, these Docs have real concerns about paying off oppressive loans and the confines that managed care demands now.... Read -the days of getting rich for most practitioners are but for the most part a thing of the past... Bariatrics is now big business and don’t you EVER believe a practitioner NOT offering a WLS procedure like the DS will likely ever HONESTLY portray said procedure in anything but a negative light. Yes, there are exceptions with a very few ethical practitioners, but this is exceedingly RARE. Frankly, I’ve seen more out and out liars in surgeons not performing the DS, universally, and seeing where even in localized seminars whereof, I have held up well researched large long-term longitudinal studies from Pub-Med contrary to the nonsense this surgeons were spouting about the DS if even addressed as option at all.
5. So back to my question, if I may? So why do you many bright inquiring folks seeking WLS or previous failed WLS interventions ignore the data, stats and well researched studies to date? Why do you continue in the self-punishment mode that IT’S ALL MY (YOUR) FAULT, and/ or my WLS choice fails me, and it’s still your fault because?? I hate the word “TOOL. Apt, perhaps, in placing the onerous ALL on you, and how very convenient in explaining ALL the failures or less than optimal long-term results and normalized lifestyle you all were hoping for.
I would be successful, BUT I found I couldn’t live with all the restrictive tools and MORE DIETING for LIFE? Why do you super morbidly obese folks like I was- knowing a medically considered success for WLS equates to losing merely only 50 % of your EXCESS weight and assuming full success in the regard, you’ll still be left morbidly obese? Bad enough a quack surgeon would perform a lap band on a 4 or 500 lb patient... Said practice borders fully on malpractice with the volumes of the sad Hx: even for the moderately obese, never mind those that qualify as MO or even less with serious comorbities.
All the anecdotal accounts just make me sick with sadness and upset because you just weren’t given adequate disclosure in my opinion. Now, so many insurance underwriters are crafting policies to state categorically you get one bite at the apple... Meaning you get one WLS per lifetime and you’re done. Period. Those that don’t have that limitation please choose a second course wisely. Stop punishing yourselves for the METABOLICALLY that did not get addressed, isn’t your fault and satellite marginal procedures that can never address same.
I’m not here stating in anyway stating the DS is for everyone. It requires an intelligent pursuit and the necessity for being your own best advocate in your labs, the few dietary demands, and lifetime supplements needed, but damn it, essentially having the luxury of living like a normal thin person with no self-imposed food restrictions at goal now is something I never thought possible. Not universal, but much more often than not with those of us longer out with the DS and even revisions to same.
Bottom line, give yourself a BREAK, it’s very often NOT your fault! Research your options thoroughly!
http://www.dsfacts.com/duodenal-switch-blog.html
Most sincerely,
Rock
Ok, so I was gifted with a medical background that allowed me to sift through some of what was the wheat from the chaff from the medical literature back then, and perhaps even more so now with my increased interest and research to date. Hardly makes me even remotely an expert, but it seems to me even the most average intellects prosecuting the most basic inquiry into morbid obesity and the surgical intervention solution sets as this simpleton learned could have come to the same conclusions. Sadly, from the posts here and all over the various boards over the years, I’m NOT seeing the enlightenment that should by now be forthcoming. 15 years ago we were not all on the net, but now that most of us are, I’m left wondering even more, “Why?" My bias is clearly more with science. Anecdotal evidence can be helpful, but it has limited utility. So much of OH posts are oriented toward the recent anecdotally proffers, and that’s perfectly fine and expected in the short-term for those having WLS. But with all the vast informational data available, I have to get back to my basic question? Why do you do this to yourselves? By that I mean have you learned anything from being morbidly obese and the challenges to this therein?
What seemed painfully obvious to me from the beginning and why not you folks?
- DIETS don’t work for 95% (+) of us. And, but for the simple rules the DS requires, one can check DIETS forever at the door! Crickey, people, have we not learned that diets don’t work?? Do NOT think for a moment, I was not every bit as DESPERATE as all of you to get the damn weight off. I was SMO at just over 400 lbs. I was not about to risk my life to just have to do what? - More dieting AFTER WLS with the very real risk of significant regain coupled with even MORE
- with essentially a MORE RESTRICTIVE diet protocol than pre-op to be, well, hopefully successful... Damn it, people, most of us have managed to get significant amounts of weight off, dieting, but we all learned KEEPING it OFF is KEY!
2. Most of us who find ourselves morbidly obese are METABOLICALLY CHALLENGED. Translation- It’s not your fault. The DS is really the only WLS intervention that addresses this quite appreciably well. So well in fact, that we can live and and eat normally without appreciable regain out long-term. Put simply, we DS Post-Ops have the very best Stats. overall for maximum excess weight loss and KEEPING it off out long-term. Not to mention the permanent resolution of comorbities, especially type 2 diabetes.
3. But no, I must be, or you’re more certainly wrong. IT IS MY FAULT! I made the wrong choices in my eating habits. Therefore, I deserve to be punished for my gluttony sins and that is singularly the reason
~ I found myself morbidly, or super morbidly obese! So, I will get my TOOL- lose weight and then no matter what, I can or will find success. Why, because all I need is a tool and damn it, I have dieted successfully in the past to wit, I got some of the weight off. Short-sighted? Do I really need to answer that?
Look, people, fat or thin we could all stand to make better choices in food consumption in the most general sense. But, should that translate in a LIFETIME of PUNISHMENT though risking your very life for WLS to do what? A regiment of more Self-Punishment at just MORE DIETING for the rest of your life? Not only more dieting, but more restrictive dieting than you have likely ever done in the past. How has dieting in the long-term worked so far? Oh, but now you have a F**ning tool... PLEASE. Just look at the posts here and elsewhere on the boards. Revision and failed WLS boards are one thing, but one only needs to look on the main OH board to see the perioperative misery and certainly that which can be seen out long term. MORE and MORE self-PUNISHMENT, meaning it’s ALL my fault! God help me because I can’t depend on this sometimes medieval dumping syndrome to control cravings? What the hell is so bad at wanting to live a normal life eating like a normally thin person does? I eat normally and drink with my meals with a few simple rules of protein and supplements first, and the rest can be gravy, often literally? Never mind, this notion one is desperate to just get he weight off and don’t what to bother appealing my rights for the WLS surgery that is best for me. I’ll worry about the dieting for life thing later after I get my TOOL and any appreciable regain, I might face is a matter for another day. Assuming- this is even disclosed adequately from the surgical practice or from one’s own in adequate research.
4.“But, but ...-my consulting PCP and Surgeon really knows what’s best for me, and this is what my insurance says they will approve." Why would I question their expertise? Here’s a clue people. Surgery is “often" largely a technical skill. Bariatric surgery is dead simple on the whole to learn for those most commonly done in this country and elsewhere. The Duodenal Switch, is MUCH more technically difficult to learn and master well as a procedure. Takes longer to perform under the knife, and sadly, insurance remuneration of such skill and said procedure is LESS for both the practitioner and hospital, ect in contrast to those more commonly performed. [I]n contrast, virtually all the other WLS interventions are a snap to learn and do with some degree of proficiency. Not all, but many, if not most Bariatric surgeons having developed a taste for surgery- demonstrate marginal promise early on in a general surgery rotation looking for a lucrative practice. Easily learned, these very often marginalized skilled challenged newbie's would be fools to pass up on this increasing low skill level financially rewarding burgeoning opportunity. And trust me, these Docs have real concerns about paying off oppressive loans and the confines that managed care demands now.... Read -the days of getting rich for most practitioners are but for the most part a thing of the past... Bariatrics is now big business and don’t you EVER believe a practitioner NOT offering a WLS procedure like the DS will likely ever HONESTLY portray said procedure in anything but a negative light. Yes, there are exceptions with a very few ethical practitioners, but this is exceedingly RARE. Frankly, I’ve seen more out and out liars in surgeons not performing the DS, universally, and seeing where even in localized seminars whereof, I have held up well researched large long-term longitudinal studies from Pub-Med contrary to the nonsense this surgeons were spouting about the DS if even addressed as option at all.
5. So back to my question, if I may? So why do you many bright inquiring folks seeking WLS or previous failed WLS interventions ignore the data, stats and well researched studies to date? Why do you continue in the self-punishment mode that IT’S ALL MY (YOUR) FAULT, and/ or my WLS choice fails me, and it’s still your fault because?? I hate the word “TOOL. Apt, perhaps, in placing the onerous ALL on you, and how very convenient in explaining ALL the failures or less than optimal long-term results and normalized lifestyle you all were hoping for.
I would be successful, BUT I found I couldn’t live with all the restrictive tools and MORE DIETING for LIFE? Why do you super morbidly obese folks like I was- knowing a medically considered success for WLS equates to losing merely only 50 % of your EXCESS weight and assuming full success in the regard, you’ll still be left morbidly obese? Bad enough a quack surgeon would perform a lap band on a 4 or 500 lb patient... Said practice borders fully on malpractice with the volumes of the sad Hx: even for the moderately obese, never mind those that qualify as MO or even less with serious comorbities.
All the anecdotal accounts just make me sick with sadness and upset because you just weren’t given adequate disclosure in my opinion. Now, so many insurance underwriters are crafting policies to state categorically you get one bite at the apple... Meaning you get one WLS per lifetime and you’re done. Period. Those that don’t have that limitation please choose a second course wisely. Stop punishing yourselves for the METABOLICALLY that did not get addressed, isn’t your fault and satellite marginal procedures that can never address same.
I’m not here stating in anyway stating the DS is for everyone. It requires an intelligent pursuit and the necessity for being your own best advocate in your labs, the few dietary demands, and lifetime supplements needed, but damn it, essentially having the luxury of living like a normal thin person with no self-imposed food restrictions at goal now is something I never thought possible. Not universal, but much more often than not with those of us longer out with the DS and even revisions to same.
Bottom line, give yourself a BREAK, it’s very often NOT your fault! Research your options thoroughly!
http://www.dsfacts.com/duodenal-switch-blog.html
Most sincerely,
Rock
I had a BPD w DS but only lost lost about 60 lbs. The other surgeon in the practice removed my gallbladder 2 years later and shortened my common channel to about 75 cm. I only lost an additional 20 lbs. Today, one year later, I have started to regain weight. I have put on 5 lbs in about 2 months. I do overeat. My doctor says that I cannot eat more than 1000 cal per day. As we all know diets don't work. Maybe I'm a food addict? All I know is that I am a 52 yo, college-educated woman with multiple health risks, a decent job and good medical knowledge. I am depressed beyond belief due to the fact that I cannot lose weight, that I cannot stop eating sweets. What is wrong with me?
My question to you is: are you getting in your 100 grams of protein a day and your water? The key is the water and protein. The more protein you eat, the longer you feel full. Stay away from the sweets! It takes about 4 days to go through carb withdrawal, but it's well worth it. Eat all protein and you won't have much room for sweets. If I am crazing a carb (chocolate is my weakness) I eat a few chocolate covered altoids and that takes care of the craving. I was a huge sweets person pre-surgery, but now I eat so much protein, that I don't even crave the sweets anymore! Make sure you're getting your 100+ grams of protein daily and see what happens. I also found that I had to eat full fat meats and cheeses.
Jodi 
I can't speak for the other poster, but I feel like this is an example of the flawed "Oh, you must be doing it wrong!" thinking that many other patients pile on the minority who didn't have much success with the DS. According to Fitday, my protein intake is between 120 and 150g per day on average, I get around 64 oz of water per day, and I can't find (or remember) the last time I had refined sugar or flour (or even a white potato, for that matter!)
Sorry if this post seems so defensive, I know you were trying to help, but I've heard "Are you remembering (x, y, or z)?" SO many times from nurses, other DS'ers, etc. The answer is yes... for 3 years now. And it tends to bruise your self esteem when you're preemptively admonished for something you're not doing. Think back to the dieting days when people said things like, "you need to lose weight, you should eat fewer sweets." when you were already on a healthy eating plan... That's what it feels like.
Sorry if this post seems so defensive, I know you were trying to help, but I've heard "Are you remembering (x, y, or z)?" SO many times from nurses, other DS'ers, etc. The answer is yes... for 3 years now. And it tends to bruise your self esteem when you're preemptively admonished for something you're not doing. Think back to the dieting days when people said things like, "you need to lose weight, you should eat fewer sweets." when you were already on a healthy eating plan... That's what it feels like.
Thanks. I didn't mean to offend anyone, but you're right; I may have come off very strong. I'm sorry if it came out that way. I know I'm new, but I work really hard every day to make sure I stay away from the sweets and eat primarily protein so that I can lose the weight, so I get kind of upset when I see people posting that they can't lose weight, but they are eating alot of sweets. I'll go back to my hole now. 
Jodi
I thought that surgery would help me
1. to not be hungry
2. to make me feel sick if I ate sweets
And by the way I eat VERY healthy and have a disease or problem with carbs and I am still searching for a miracle. Don't tell me that you "work really hard" . If you are such a perfect eater you would not have needed surgery.
The truth is that everyone who is overweight overeats. At least I'm honest.
1. to not be hungry
2. to make me feel sick if I ate sweets
And by the way I eat VERY healthy and have a disease or problem with carbs and I am still searching for a miracle. Don't tell me that you "work really hard" . If you are such a perfect eater you would not have needed surgery.
The truth is that everyone who is overweight overeats. At least I'm honest.
"The truth is that everyone who is overweight overeats" - SO TRUE!
Regarding #1, I don't know if you went through the same thing, but did you find that back in the early post-op days you were hungry as ever, (both stomach-hungry and mind hungry,) but physically couldn't satisfy that need? That was a horrible experience.
Regarding #1, I don't know if you went through the same thing, but did you find that back in the early post-op days you were hungry as ever, (both stomach-hungry and mind hungry,) but physically couldn't satisfy that need? That was a horrible experience.
Yes, part of my early difficulty was that (especially early on) it hurt to eat meat protein and softer foods were easier to overeat because they didn't hurt.
You are right on the money about mind-hungry. That is a real challenge. I tried hypnosis once but it didn't work. I really liked the people that I met at OA but that didn't work either. The only other time that I lost a substantial amount of weight was when I starved myself. I was much younger and didn't realize how bad it was for me. I sometimes wonder if that contributed to the seriousness of my problem now.
You are right on the money about mind-hungry. That is a real challenge. I tried hypnosis once but it didn't work. I really liked the people that I met at OA but that didn't work either. The only other time that I lost a substantial amount of weight was when I starved myself. I was much younger and didn't realize how bad it was for me. I sometimes wonder if that contributed to the seriousness of my problem now.
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