New to the board

Hey Guys,
I've been lurking for a little while now and thought I'd introduce myself.

I'm just in the beginning stages of researching WLS and the options availalbe to me.  I had set my sights on a VSG, but my insurance has informed me that they only cover the band and RNY as the VSG is 'experimental.'  (Didn't ask about DS).  So I'm currently arguing with myself about band vs RNY.

My story is probably the same as most of yours -- I'm 36, been overweight for a long time (probably since I was 10-11 or so.  I'm 6'3" and as an adult my weight has swung from 290-420.  Am married with a step-son and we are trying to have another child.  Would kind of like to be around to see my step-son grow up and our potential other child as well.

I have had really good short term success on diets (I lose very fast when limiting my caloric intake to anything below 1700 calories a day).  However, like most people, I lose the momentum and desire to continue and I have nothing that prevents me from being on a diet one day, and then destroying a buffet the next day.

I've always been a volume eater.  Sweets really aren't my gig (although I do like them from time to time).  For me, the only thing better than a huge plate of food, is a second huge plate of food.

I am hoping that WLS will be a tool to help prevent me from living in that mindset long enough until I can adopt and embrace real change in the way I live my life. 

I really enjoy reading through your successes and problem solving.  Just wanted to share a bit about me.

Thanks,
joshua

One nice thing -- after talking to my insurance -- they basically told me that I just need to talk to one of their approved surgeons and once we are satsified I should have the surgery and have met the doctor's pre-op requirements, we schedule the surgery and get it approved.  It seems to be a very smooth,easy process.

It's a little unnerving that once I get it in gear, it could all be over very fast.  I read where most people look at 6+ months of waiting, and depending on my surgeon, it could be much quicker than that for me.

I should consider myself lucky.

Welcome, Josh - always room in the locker room!

Lots of good comments so far - let me offer one from the insurance point you made.  When I heard it would take a minimum of six months consecutive nutritional counseling before my carrier would consider my surgery request , I was not happy.  I was ready NOW!

But those six months ended up being the best six months I could have spent.  I read voraciously on WLS.  I studied the eating plans.  I tried protein powders and slimfast type drinks to see what I liked.  I thought through a lot of the things that are being asked on this board lately.  I visualized a lot of what happened.

So when my surgery date came, I was informed - I was eager - I was ready!  And my post-op stuff has gone very smoothly because of that preparation.  Soak up the knowledge so that you can be an informed patient and proactive in your new life!

Josh. Welcome to the forum.   VSG is not experimental it is proven many USA Dr's and bariatric centers perform it.  I think you can appeal or something to get the VSG approved.  Talk to your Drs office they know how to get it done.

I was the same way you are, Volume eater and still like to have sweets now and then.  lol Volume no more. I can have sweets if I want.

Where are you located in the world?

Welcome to the board.  It's a great place with a lot of good guys.  You'll get lots of info and help here.

 From what you've written it sounds to me like you'd be better off with a RNY.  I was always the same way.  I could lose the weight on a diet but then I'd go back to my old ways of eating and usually get hurt exercising or just stop exercising and the weight would come back.

Talk to your surgeon about the options.  I think that with the right attitude and discipline any of them will work but remember you have to work too.  Some of the WLS tools just takes a little more work from you than others do.
Duane

I'm in San Diego.

I agree that from what I have read RNY seems like a better option for loss and long term sustainability.  I am concerned (and need to talk to a doctor about this) about the long term consequences of the RNY as it pertains to health maintenance and late life complications.

I still don't know enough about the RNY to make an informed choice about it.  However, just on the surface -- I would prefer to have as little replumbing as possible.  I may change my mind as I learn more.  Just don't know at this point.

One of the other things that concerns me about RNY (or DS for that matter) is  every extra incision or suture or reroute is another opportunity for problems.  My mother had VSG 16 months ago and the doc (completely accidentally) shanked her liver and didn't notice.  She was having lots of problems and had to go in for a second surgery a week later (again, doctor thought it was normal seepage bacause she was on blood thinners prior to the surgery and thought it was just taking a bit longer for her body to heal).  They eventually figured it out and fixed her -- was scarily touch and go and I had the unpleasant experience of visiting her in the hospital when they were discussing how many units of plasma they had given her.

 I had really considered the Lap Band at one time.  Once I did some more research I decided it was not for me.  I've know too many people who've had it done and didn't really lose any weight.  Plus I worried about the fills that you have to get done.  It can be costly depending on your insurance and surgeon.  Plus, it lets you cheat and I know that if I could I would.  I really didn't know much about the VSG and still don't so I'll not make any comments pro or con about it.  The DS has it's good and bad points.  Just gather all the info you can and make the best informed decision that you can.  Watch getting over into the main boards as there is a lot of fighting about what procedure is best.  It can really get you down reading all of that stuff.  You'll get good support here no matter what you choose.
Duane

1  Because you are a volume eater, I would recommend the RNY.  You'd definitely be restrcted on what you can eat at any one meal.

2.  Since you already know that you can lose weight if you keep yourself at under 1,700 cal, I suggest that you get the Beck's Diet Solution which will teach you how to stay on any nurtitional diet.  I stll see the need for the WLS, but the strategies discussed in the book will help you stay on your pre-op and post-op diets.  If you have already started to diet before getting the book, read the first 4 chapters and start the program with chapter 5 and continue dieting.  Dr Beck suggests not dieting until day 15 of the 42 day program if you are not on a diet.  That way you can learn the strategies necessary to stay on a diet.  Remember that her book is aimed at all people who want to stay on diets.  We are a special class of people since we start out as being morbidly obese.  I.E., take what she says with a grain of salt.

3  Although some doctors do make mistakes, you can increase the odds in your favor by researching which surgeon you want to perform the WLS.  When I had my first RNY in 2000, there were few doctors doing them and they were mostly trained specifically for WLS in addition to their regular surgeries.  In the next couple of years, when insurance companies began approving WLS on a fairly regular basis, more and more surgeons started to do them.--See how many WLS surgeries your surgeon has done.  He/she may be an excellent surgeon, but I wouldn't want to be their first ( or maybe even their 10th) WLS patient.  Look for how many WLS they have done and what type.  And, check on their surgical records.  By the way, I needed a revised RNY in Jan 2005 because of a staple line disruption.

Welcome aboard Josh! Great bunch of guys with lots of personal knowledge and experience, and some good ol' BS'ing too.  No question is too "dumb", we all had ours too.

I started out with the intention of having the lap band, but the Doc's all told me that RNY was the best option for me to be successful over the long haul.  I took their expert advice and am glad I did.

This is major surgery and you need to read, research, ask questions and then do it again. If you can find some folks who have had WLS (RNY, Band, DS, etc.) and wil share their personal experiences with you, that may help you out. It did me. WLS is a major lifestyle change, but it is also an awesome tool to help you have a healthier, longer and happier life, provided you are willing to follow the rules, exercise and do your part.  Personally, I believe it's the best thing I have ever done to help myself since I had my heart attacks seven years ago. After researching, talking with my cardiologist and family physician, my wife and looking at how my weight was ballooning up and my health was spiraling downward, I decided the potential benefits far outwighed the risks involved with the surgery.

Bottom line is that this is YOUR decision and you have to do what you decide is right for you.

So, jump on in, ask questions,  make comments and join in on the fun. Best of luck with whatever YOU decide.

Welcome.  You might want to repost this on the California Board...tell them you're from SD.  Many locals may be able to help you.  Others know how to start the process (through the state) to get an appeal going for the surgery you want...and you and your doctor feel you need.  Brian