(Another) Introduction/Question: Surgery options - weight Regain
Good Afternoon Fellas,
I've been roaming around these boards and wanted to officially introduce myself on the Men's side of things. I'm 29 years old, married, and recently (~4months) have decided that WLS is going to be a good option for me to try and regain my life back. Like many/all of us I've dieted since my pre-teens (first doctor monitored diet was at age 12) and have gone up and down ever since - mostly up! I'm currently at 368lbs, having just gained 8lbs in the past 10 days. It's episodes like this that have made my life crazy. This was 10 lbs of weight gain without going out to eat, without binging, without truly changing what I've been eating... The only thing that I can see was different was that stress at work was elevated. When I gain weight like this and try to get those extra 8-10-15-20 lbs off it always seems I take 1 step down in weight with 2 up. I'm hoping this sounds familiar to some and that I'm not nature's oddity. Ha! Having come to the realization that WLS is going to be a real option for me to utilize I've come down the the question of "What surgery is right for me?" And at first I was convinced that this was the duodenal switch (As my user name suggests). I'm a healthcare professional and I knew about the duodenal switch and also about all of the potential postop complications/supplementation/followup/labs that were required - or death. Naturally, this scare the holy ______ out of me but so did/does the thought of having a heart attack in my 30s or walking with a cane/walker because my hips/knees are already shot. I convinced myself that I was able/willing to put myself first and put my nose to the grindstone to make the most out of a major life altering surgery. Seeing that I have ~200lbs to lose to be my "ideal weight" and having a BMI of 55 it seemed the only real option. Then doubt crept in. After I began talking about this surgery with my wife and going over the aftercare/supplementation/labs/potential complications/potential macro-micronutrient malnutrition she kind of raised an eyebrow and said something to the effect, "Are you serious?" To her the risks were way more than the benefits. She expressed her concern either way - with or without surgery - that I may die and she felt they were pretty equal in looking at the DS vs staying SMO. I spoke to two different surgeons by phone. One was a DS surgeon and one was not (though planned on learning/performing the procedure in the future). The non-DS surgeon basically said that since I was "so young" and would have live with the "high maintenance" aftercare of the DS that I should really consider a stand alone VSG. I raised my concern about long-term maintenance to which he said if I really had an issue with long-term maintenance then the option of revising to the DS was there. He said that I would likely do well/lose weight with either but that with the VSG I may not reach goal (~160-170). My conversation with the DS surgeon went similarly - that because the aftercare of the DS was so rigorous he (without saying it as plainly as the other surgeon) recommended the VSG and that he had a patient who weighed over 600lbs who was now ~220lbs 3 years out from a VSG and that this patient was in his 60s and was disabled! That made me feel a little more confident in the power of the VSG but this was just one case. He did offer that he was performing DS's with longer common channels within the past 2 years as he had more patients end up with vitamin/mineral deficiencies (mostly Vit D and Calcium) when he did some channels 50-75cm. The one complication that is up in the air with everyone, he said, was iron deficiency anemia. With iron being absorbed mostly in the duodenum you have to count on the other areas to absorb an adequate amount. So if one's other areas don't absorb an adequate amount one will go on to require iron infusions - likely chronic. He basically left the ultimate call up to me - if I felt able to follow a stringent aftercare plan with multiple supplementations/labwork and dealing with the possibility of chronic iron infusions then I would be a good DS patient. If, in my heart of hearts, I don't think I can religiously adhere to said protocol, then the VSG would be my best option (noting that there's still postop supplementation/labwork but not nearly as numerous). His other concern with a young person having a DS is that no one knows what would happen 30-40 years down the road. My worries regarding the VSG: I feel it's an ultimate "diet tool." What I mean by that is that by nature, it's a restrictive procedure. So, yes, I would eat much less, and would have some time to "reset" myself to better thinking about food/relationship with food. But is that enough? I didn't get to the way I think about food over one - three years, is it truly reasonable to think that I can "reset" myself to think as a "normal thin person" thinks? Admittedly, I have eaten myself sick, I am certainly a voluminous eater plus I eat the "wrong things" (I'm convinced that there's a sick joke in nature that everything that's bad for you tastes great!) so I wonder if a "surgical diet" would ultimately work for me without the backup of malabsorption. I'm not saying this would be a fail-safe but at least some extra power in my corner. I realize ultimately I have to regain the power over what I put into my body for nutrition and sustenance - not quite so much for pure enjoyment or comfort. Though if it was really that easy I would've accomplished that by now. Am I way off base with any of my thoughts? Are there other variables I should be considering that I'm currently not? I would really like to hear opinions from those experienced with either type of surgery to see what ultimately led you to one vs the other. Thank you all for indulging this lengthy post. I'm looking forward to being a part of this board!
I've been roaming around these boards and wanted to officially introduce myself on the Men's side of things. I'm 29 years old, married, and recently (~4months) have decided that WLS is going to be a good option for me to try and regain my life back. Like many/all of us I've dieted since my pre-teens (first doctor monitored diet was at age 12) and have gone up and down ever since - mostly up! I'm currently at 368lbs, having just gained 8lbs in the past 10 days. It's episodes like this that have made my life crazy. This was 10 lbs of weight gain without going out to eat, without binging, without truly changing what I've been eating... The only thing that I can see was different was that stress at work was elevated. When I gain weight like this and try to get those extra 8-10-15-20 lbs off it always seems I take 1 step down in weight with 2 up. I'm hoping this sounds familiar to some and that I'm not nature's oddity. Ha! Having come to the realization that WLS is going to be a real option for me to utilize I've come down the the question of "What surgery is right for me?" And at first I was convinced that this was the duodenal switch (As my user name suggests). I'm a healthcare professional and I knew about the duodenal switch and also about all of the potential postop complications/supplementation/followup/labs that were required - or death. Naturally, this scare the holy ______ out of me but so did/does the thought of having a heart attack in my 30s or walking with a cane/walker because my hips/knees are already shot. I convinced myself that I was able/willing to put myself first and put my nose to the grindstone to make the most out of a major life altering surgery. Seeing that I have ~200lbs to lose to be my "ideal weight" and having a BMI of 55 it seemed the only real option. Then doubt crept in. After I began talking about this surgery with my wife and going over the aftercare/supplementation/labs/potential complications/potential macro-micronutrient malnutrition she kind of raised an eyebrow and said something to the effect, "Are you serious?" To her the risks were way more than the benefits. She expressed her concern either way - with or without surgery - that I may die and she felt they were pretty equal in looking at the DS vs staying SMO. I spoke to two different surgeons by phone. One was a DS surgeon and one was not (though planned on learning/performing the procedure in the future). The non-DS surgeon basically said that since I was "so young" and would have live with the "high maintenance" aftercare of the DS that I should really consider a stand alone VSG. I raised my concern about long-term maintenance to which he said if I really had an issue with long-term maintenance then the option of revising to the DS was there. He said that I would likely do well/lose weight with either but that with the VSG I may not reach goal (~160-170). My conversation with the DS surgeon went similarly - that because the aftercare of the DS was so rigorous he (without saying it as plainly as the other surgeon) recommended the VSG and that he had a patient who weighed over 600lbs who was now ~220lbs 3 years out from a VSG and that this patient was in his 60s and was disabled! That made me feel a little more confident in the power of the VSG but this was just one case. He did offer that he was performing DS's with longer common channels within the past 2 years as he had more patients end up with vitamin/mineral deficiencies (mostly Vit D and Calcium) when he did some channels 50-75cm. The one complication that is up in the air with everyone, he said, was iron deficiency anemia. With iron being absorbed mostly in the duodenum you have to count on the other areas to absorb an adequate amount. So if one's other areas don't absorb an adequate amount one will go on to require iron infusions - likely chronic. He basically left the ultimate call up to me - if I felt able to follow a stringent aftercare plan with multiple supplementations/labwork and dealing with the possibility of chronic iron infusions then I would be a good DS patient. If, in my heart of hearts, I don't think I can religiously adhere to said protocol, then the VSG would be my best option (noting that there's still postop supplementation/labwork but not nearly as numerous). His other concern with a young person having a DS is that no one knows what would happen 30-40 years down the road. My worries regarding the VSG: I feel it's an ultimate "diet tool." What I mean by that is that by nature, it's a restrictive procedure. So, yes, I would eat much less, and would have some time to "reset" myself to better thinking about food/relationship with food. But is that enough? I didn't get to the way I think about food over one - three years, is it truly reasonable to think that I can "reset" myself to think as a "normal thin person" thinks? Admittedly, I have eaten myself sick, I am certainly a voluminous eater plus I eat the "wrong things" (I'm convinced that there's a sick joke in nature that everything that's bad for you tastes great!) so I wonder if a "surgical diet" would ultimately work for me without the backup of malabsorption. I'm not saying this would be a fail-safe but at least some extra power in my corner. I realize ultimately I have to regain the power over what I put into my body for nutrition and sustenance - not quite so much for pure enjoyment or comfort. Though if it was really that easy I would've accomplished that by now. Am I way off base with any of my thoughts? Are there other variables I should be considering that I'm currently not? I would really like to hear opinions from those experienced with either type of surgery to see what ultimately led you to one vs the other. Thank you all for indulging this lengthy post. I'm looking forward to being a part of this board!
Switch Me,
Sounds like you have done your homework and applied it to your situation.
Regardless of the surgery you choose remember the surgeries are a tool to get your eating under control and become a more active and healthier person. Is it the "easy way"? Not "no" but "Hell no!" It takes a lot of disipline to adjust your eating habits and becoming more physically active especially if you've been sedentary most of your life.
Welcome and pitch in any time!
Sounds like you have done your homework and applied it to your situation.
Regardless of the surgery you choose remember the surgeries are a tool to get your eating under control and become a more active and healthier person. Is it the "easy way"? Not "no" but "Hell no!" It takes a lot of disipline to adjust your eating habits and becoming more physically active especially if you've been sedentary most of your life.
Welcome and pitch in any time!
Never, and I mean NEVER, trust a fart!! 
Don,
Thanks for the welcome! First, let me apologize for my first post coming through as one giant paragraph! I'm not sure what happened but my paragraphs seemed to just collapse into one!
I sincerely realize that surgery is NOT the easy way out. I have actually known two others who have had WLS with poor results because they thought that it was an easy way out - they were proof that it isn't! I think the hardest thing for me will be to confront and *change* my "use" of food. What I feel is my ultimate downfall is my use of food almost as a drug... It'd almost be nice to be in a situation where food was for survival only - like that scene in The Matrix where they're eating this snot-like gruel, but it had all the vitamins and mineral's the body needed!
I like being active but I can't stand the gym - I'm not a big one for running in place. Mindless cardio makes me go insane but I do enjoy weight training. Heck, it'd even be nice to go for a walk around the park with my wife for a change!
Thanks very much for your words and welcome!
Thanks for the welcome! First, let me apologize for my first post coming through as one giant paragraph! I'm not sure what happened but my paragraphs seemed to just collapse into one!
I sincerely realize that surgery is NOT the easy way out. I have actually known two others who have had WLS with poor results because they thought that it was an easy way out - they were proof that it isn't! I think the hardest thing for me will be to confront and *change* my "use" of food. What I feel is my ultimate downfall is my use of food almost as a drug... It'd almost be nice to be in a situation where food was for survival only - like that scene in The Matrix where they're eating this snot-like gruel, but it had all the vitamins and mineral's the body needed!
I like being active but I can't stand the gym - I'm not a big one for running in place. Mindless cardio makes me go insane but I do enjoy weight training. Heck, it'd even be nice to go for a walk around the park with my wife for a change!
Thanks very much for your words and welcome!
Switch Me,
Greetings and Welcome!!!!
I feel your pain. First of all, no, you are aren't special! Everyone here has the same problem with losing 5, gaining 8, losing 10, gaining 15... It is a vicious cycle, and one that I was not able to break on my own, or even under a Doctors care following a "supervised" diet.
I went through the same stuff, when I decided to start my journey around this time last year. I went through researching every type of surgery out there. I looked at all of them, and finally settled on the VSG. I agree with your surgeon, the decision is yours and yours alone. Doing your research is very smart, and I have found that this place is a great place to get info. I wish you luck in your process and journey.
Now, with all that being said... I chose the VSG because it didn't have the same malabsorptive properties of the other surgeries. (I never really considered the Lap-Band. I think it is a complete waste of money for those *****ally need surgical assistance and a considerable amount of weight to lose. This is based solely on my personal experiences, and not meant to disparage the band or anyone who has had it) I had, and to a certain extent still have today, the same concerns about failing without the malabsorptive properties of the RNY or DS, but ultimately decided that I wanted to try to minimize possible complications, and not set myself up for future health problems related to malabsoption.
I had my VSG two weeks ago, on August 30th, and so far have done very well. I know it has only been two weeks, and this is a lifelong process, but so far, so good! I was worried about portion control and making smart choices with my foods, but have had NO ISSUES so far with that. I do watch my wife eat pizza and other things and it makes me miss eating it, but my motivation comes from the same place that drove me to get the surgery in the first place. Luckily, if you have insurance, they are going to make you jump through a bunch of hoops, and that will help you with the necessary "retraining". It will still take daily work, but if you really want it, you will make it happen!
I don't want to sway you toward the VSG over anything else, and think all of them (my previous comments on the band still standing) are very much useful and each have a place in the world. You just have to look at each, educate yourself on them, talk to your family, and the decide which one is the right one for you. (Having your wife on board is going to be very important. If you think it won't affect your family just as much as you, you are wrong. Be sure her concerns are taken seriously and she is at peace with your decision as much as possible. Luckily, my wife is about 2 weeks out from her surgery, and we are going to do it together.)
Good luck sir, and if you have any other questions I might be able to help with, don't hesitate to ask. I am no expert, but I spend A LOT of time on here, and amd learning first hand every morning when I wake up. At 2 weeks post-VSG, my only regret is that I didn't do it a whole lot sooner!!!! (I am 33)
Greetings and Welcome!!!!
I feel your pain. First of all, no, you are aren't special! Everyone here has the same problem with losing 5, gaining 8, losing 10, gaining 15... It is a vicious cycle, and one that I was not able to break on my own, or even under a Doctors care following a "supervised" diet.
I went through the same stuff, when I decided to start my journey around this time last year. I went through researching every type of surgery out there. I looked at all of them, and finally settled on the VSG. I agree with your surgeon, the decision is yours and yours alone. Doing your research is very smart, and I have found that this place is a great place to get info. I wish you luck in your process and journey.
Now, with all that being said... I chose the VSG because it didn't have the same malabsorptive properties of the other surgeries. (I never really considered the Lap-Band. I think it is a complete waste of money for those *****ally need surgical assistance and a considerable amount of weight to lose. This is based solely on my personal experiences, and not meant to disparage the band or anyone who has had it) I had, and to a certain extent still have today, the same concerns about failing without the malabsorptive properties of the RNY or DS, but ultimately decided that I wanted to try to minimize possible complications, and not set myself up for future health problems related to malabsoption.
I had my VSG two weeks ago, on August 30th, and so far have done very well. I know it has only been two weeks, and this is a lifelong process, but so far, so good! I was worried about portion control and making smart choices with my foods, but have had NO ISSUES so far with that. I do watch my wife eat pizza and other things and it makes me miss eating it, but my motivation comes from the same place that drove me to get the surgery in the first place. Luckily, if you have insurance, they are going to make you jump through a bunch of hoops, and that will help you with the necessary "retraining". It will still take daily work, but if you really want it, you will make it happen!
I don't want to sway you toward the VSG over anything else, and think all of them (my previous comments on the band still standing) are very much useful and each have a place in the world. You just have to look at each, educate yourself on them, talk to your family, and the decide which one is the right one for you. (Having your wife on board is going to be very important. If you think it won't affect your family just as much as you, you are wrong. Be sure her concerns are taken seriously and she is at peace with your decision as much as possible. Luckily, my wife is about 2 weeks out from her surgery, and we are going to do it together.)
Good luck sir, and if you have any other questions I might be able to help with, don't hesitate to ask. I am no expert, but I spend A LOT of time on here, and amd learning first hand every morning when I wake up. At 2 weeks post-VSG, my only regret is that I didn't do it a whole lot sooner!!!! (I am 33)
HW: 429 SW: 380 Height: 5'08"
Charlie,
Thanks for the great reply! I can relate almost exactly to your experience leading up to surgery. It certainly strikes a chord. I have few comorbidities (only sleep apnea that I know of) so that is the one thing really pushing me toward the VSG rather than DS. If I had a boat load of comorbidities and was on a handful of meds every day I think my answer would be clear to go with the DS. I *do* however have a strong family history of severe problems (Dad had congestive heart failure at 35 secondary to dilated cardiomyopathy, Mom and Dad have hyperlipidemia, hypercholesterolemia, hyperension, Mom has diabetes and various orthopaedic issues as well) and I'm trying to be as premptive about this as possible. This being said - it's been about 3 years since I've had "regular" labs drawn so I'm going to be establishing with a new PCP after having moved about 3 months ago. What I've told myself is that if any new things have raised their evil heads - diabetes for sure, or high lipids or cholesterol, this may be more of a reason to go with the DS as the statistics are better for ultimate resolution of such issues (not without a great deal of work obviously).
I really wouldn't look forward to malabsorption and agree it can almost be like trading one ailment (obesity) for another (micro/macronutrient malnutrition). I do like the minimalistic approach of the VSG and like the decrease seen in serum grehlin levels as well!
Again, thanks for your post! I wish you the best of success with your VSG! It's a powerful tool for sure! It's great that you have your wife going through that with you as well. My wife is lucky enough to not have MO as an issue for her. She is supportive of me moving forward with surgery, she just doesn't want me to end up sicker than i already am! And I love her for that input! She's my rock!
Thanks for the great reply! I can relate almost exactly to your experience leading up to surgery. It certainly strikes a chord. I have few comorbidities (only sleep apnea that I know of) so that is the one thing really pushing me toward the VSG rather than DS. If I had a boat load of comorbidities and was on a handful of meds every day I think my answer would be clear to go with the DS. I *do* however have a strong family history of severe problems (Dad had congestive heart failure at 35 secondary to dilated cardiomyopathy, Mom and Dad have hyperlipidemia, hypercholesterolemia, hyperension, Mom has diabetes and various orthopaedic issues as well) and I'm trying to be as premptive about this as possible. This being said - it's been about 3 years since I've had "regular" labs drawn so I'm going to be establishing with a new PCP after having moved about 3 months ago. What I've told myself is that if any new things have raised their evil heads - diabetes for sure, or high lipids or cholesterol, this may be more of a reason to go with the DS as the statistics are better for ultimate resolution of such issues (not without a great deal of work obviously).
I really wouldn't look forward to malabsorption and agree it can almost be like trading one ailment (obesity) for another (micro/macronutrient malnutrition). I do like the minimalistic approach of the VSG and like the decrease seen in serum grehlin levels as well!
Again, thanks for your post! I wish you the best of success with your VSG! It's a powerful tool for sure! It's great that you have your wife going through that with you as well. My wife is lucky enough to not have MO as an issue for her. She is supportive of me moving forward with surgery, she just doesn't want me to end up sicker than i already am! And I love her for that input! She's my rock!
Looks and sounds to me like you are on the right track. You seem very well educated to this point, and are looking at all the right things! Keep your head up, keep your determination, and get your health under control before it does get out of hand. (I had NO comorbities until 2 months before surgery, when my doctor put me on a very low dose of high blood pressure meds. As in unmedicated, I was running about 135/90.)
So, I feel your pain! Again, let us know if we can help in any way, and you can always message me privately if you have specific questions about VSG or my situation and want answers!
So, I feel your pain! Again, let us know if we can help in any way, and you can always message me privately if you have specific questions about VSG or my situation and want answers!
HW: 429 SW: 380 Height: 5'08"
My suggestion is to look at the pros and cons of a sleeve, RNY and a DS. How does the post op life style of these three surgeries fit into your life? Which of these options is going to be best for you overall?
I chose to have an RNY, because at the time, it was a choice between RNY and a lap band and I knew that i would not do well with a lap band. I did not want to travel for a DS, it was important to me to have my surgeon near by if I had an issue. A sleeve was not really common place at that time.
Like Don has said, this is a tool. You need to decided if you want to use a claw hammer or a ball peen hammer. You need to decide which tool is the best fit for you. Good luck
Jim
I chose to have an RNY, because at the time, it was a choice between RNY and a lap band and I knew that i would not do well with a lap band. I did not want to travel for a DS, it was important to me to have my surgeon near by if I had an issue. A sleeve was not really common place at that time.
Like Don has said, this is a tool. You need to decided if you want to use a claw hammer or a ball peen hammer. You need to decide which tool is the best fit for you. Good luck
Jim
Charlie and Jim:
Thank you both for your comments! Everything is certainly food for thought and consideration. I've really got some heavy duty thinking and soul searching to do before I settle on a decision. If I come to any stalemates with myself I'll be sure to throw a question out here and there.
Thanks for your support! Keep on rockin those surgeries!
Thank you both for your comments! Everything is certainly food for thought and consideration. I've really got some heavy duty thinking and soul searching to do before I settle on a decision. If I come to any stalemates with myself I'll be sure to throw a question out here and there.
Thanks for your support! Keep on rockin those surgeries!
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