Feeling sad and Hopeless

Cheryl K.
on 1/20/12 6:20 am - Hoquiam, WA
RNY on 03/30/12 with
I am having a really messed up day.  I have been talking to Dr. Aceves office for the past couple of weeks about getting the RNY bypass.  As many I have to be a self pay due to having a prejudiced insurance company. (Anything to do with weight is excluded) blah blah blah.  Well, I was just told by Nina (very nice lady) that

I am sorry to say you have not been approved for the bypass  surgery. Being a revision surgery and  with your BMI  we can only offer the gastric sleeve surgery laparoscopically with Dr. Aceves.  We have done many high BMI patients like yourself and the weight loss is very similar to the bypass and the surgery is much much safer. 

So, I don't know what to do.  I was a self pay 6 years ago in the US for a lapband.  It did not work for me at all.  After paying $17,000 I am afraid the gastric sleeve will be the same kind of thing.  I fear that I really need the bypass to be successfull.  My as of today i weigh 480.2 lbs and am 5'7 with a bmi of 75.2.  

I guess I am looking for some advise.  I would like to check into another surgen if anyone knows of a good one in mexico that does the RNY.  Also, would love to hear from people who have had the sleeve that is around my size and what they think about it.

Any and all help would be GREAT!!

Sad tears today.

        
Lori P.
on 1/20/12 11:08 am - Kenosha, WI
The sleeve is the first part of the DS and is often done in stages for higher BMI folks.  That way if the sleeve does not prove to be fully effective, you can then move on to the DS. 

You might want to post on thesleeve and the DS boards to get replies from people that may have ahd a similar expereince. 

 



     SW 212 / Goal 130 / Current 130


 

 

Cheryl K.
on 1/20/12 11:54 am - Hoquiam, WA
RNY on 03/30/12 with
 Thank you so much for your help :-)
Margo N.
on 1/21/12 6:18 am
I had a sleeve with Dr Aceves and have been very happy with it - having said that, I am in a category of people for whom the sleeve is likely to be pretty effective - low BMI, no major history of diet/regain etc. Having said that, I know of some high BMI people who also have been successful with the sleeve

There are a couple things to consider - first, what were the reasons that the lapband was unsuccessful? If the lapband was working as it should with respect to restricting the amount of food you ate, then it is possible that a restriction-only surgery such as the sleeve may not be sufficient to help you lose as much as you would like to lose. The advantage of sleeve instead of lapband are significantly reduced hunger (for most people, not all) and a lower rate of post-op complications such as slipping erosion etc, Once you have finished your surgery and assuming you have not had a leak, the risk of complications is very low. Aceves has a very good track record in terms of a low complication rate, so I think the surgery is generally very safe.

Second, although the RNY does provide some malabsorption, and RNY patients tend to have an initial rate of weight loss that ismore rapid than with the sleeve, the malabsorptive effects with respect to calories tend to reduce after a few years out, leaving you mostly with restriction, (Like the sleeve) to manage weight loss / prevent regain. (You will continue to malabsorb nutrients, and need to continue to supplement for life). Long term % of excess weight loss is comparable for RNY and VSG.

Third, you might look into the DS. I know that Dr Ungson in Mexico is vetted on the DS board and does them. I have heard of Dr Aceves doing one or more under the supervision of Dr Ungson but don't now if this is an ongoing service.

For people with very high BMI and/or metabobolic conditions that make it hard to lose weight, the DS is a very good option, and it has the best stats of the four major surgeries (Lapband, RNY, Sleeve, DS) with respect to % of weight lost as well as maintaining that loss over time.

The major disadvantage of the DS is that you MUST be very vigilant about your supplementation and tracking your labs post op.... especially since you are going overseas and will absolutely have to educate your physician at home about the reconfigured anatomy of DS, the labs you will need done on a regular basis andyour supplementation needs.  If you don't have the means or the inclination to do so, then you should consider the sleeve - with the VSG you still need to be taking supplements and tracking labs. but the consequences of slipping up a bit are not as likely to be life-threateningly serious as they potentially are with the DS.

If you are considering the DS (and it is the only one of the surgeries other than the VSG that I was interested in) I highly recommend you go to the DS board for advice and info. The folks who post there, an opionated bunch, are very well-informed and can provide good advice and info. I would also ask Dr Aceves what he thinks about the DS option for you. I found him to be a very thoughtful and straight-talking Dr, and would definitely take his perspective into consideration.

Good luck - and don't lose hope - I am sure there is a solution out there that will work for you!
Margo - Burnaby, British Columbia HW 283 / SW 269 / GW 160 (I'm 5'8")
Check out my blog at http://www.vsggoodlife.com/






BillieF
on 1/22/12 11:35 pm - prince albert, Canada
I went to Dr Joya on April19 2010. My weight at the time was 594lbs with a BMI of 84. He tried to talk me into RNY but i  Insisted on the vsg as i didn't want the melaobstion problems. I am glad i stuck with the vsg as i have lost 384lbs i am now at 210lbs and really like being at this weight.I will answerer any questions you have...

Billie
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