Where do I start?

Hi! My name is Brianna, I'm 25 years old, live in Keizer, and have been overweight since I was a kid. I'm about 5'10-5'11 and I weigh around 360-370lbs but I'm not sure exactly how much because the regular scales won't weigh me *sob*. I have started thinking about weight loss surgery recently, I have tried weigh****chers, jenny craig, atkins and here I sit fat as ever. I'm so depressed all the time and don't want to go anywhere because I'm so fat. I can hardly walk up the stairs I get out of breath so easy doing anything! I have 2 kids under 2, it's so hard for me to play with the older one because I'm so fat. My life is being ruined because I'm so fat, I could go on and on. Point being, I NEED to lose weight. Heart disease and diabetes run HEAVILY in my family, I know if I don't do this, I will die early. I want to be around so I can enjoy my grandkids, I want to be healthy for my kids, and for myself and my boyfriend. I honestly dont' think I can achieve that through weight loss programs. I have SO much weight to lose and I've tried many diets so I think I'm a good candidate. I'm also on SSI because of my mental illness problems (major reoccuring depression) but I think there's a possibility that losing weight and getting in shape will help tremendously with my mental disability, I will probably have to keep taking my medicine but I'm ok with that . I'm on OHP and Medicare and from what I understand Medicare might cover it. BUT I have no idea where to start, who to go to, who to talk to, who I can lean on for support, etc First off, I need to research more, I need to find out A- what would be the best surgery for me B- Who does this surgery C- What steps I need to take to get covered for the surgery and so on Any advice/help/suggestions is GREATLY appreciated PS- here is a recent pic of me on Christmas http://home.comcast.net/~soulfirepoet1/brianna1.jpg

Brianna - From what I understand Medicare does pay. I can't say for sure, but I would start with a bariatric surgeon and present it to them. They can walk you through the steps. As for who does this surgery - well, go to state resources and you will find a list of surgeons all over that perform the surgery. Then come here and ask about ones you think you might be interested in seeing or read up on who people had and what they think of them. On the type of surgery, it's a hard choice, that is to be sure. Here are some things to ask yourself. Keep in mind that I had an open RNY, so even if I don't intend to, it might appear I lean that way. I think ALL surgeries have their value and place for different people. I detest it when people get into a mode of one being better than the other. It is so subjective. That being said, I'll start with what I understand to be true and you can research on them further. RNY (aka Roux-en-y): This is the classic "gold standard" gastric bypass. It creates a pouch at the top of your stomach where it is separated from the lower stomach. The intestine is attached to the pouch *and* to the old stomach (in a Y formation). The old stomach still produces gastric juices, but you utilize only the pouch which varies in size from the size of a grape (15 ml) to 4 ounces. Generally most are 2 ounces (the size of an egg). Because there is no sphincter on the pouch like you have with your regular stomach, contents can empty directly into the intestine (although the hole is made small enough to keep it from just rushing into it). This means you get dumping syndrome if you eat sugar. This is a BIG help in aversion therapy. Most folks when they dump, they don't want to repeat the experience so they avoid sugar. Some people don't have the problem with it though, but the majority do. Dumping is when the sugar hits the intestine and the body thinks there is a sugar emergency, so the pancreas dumps out too much insulin. This results in a variety of symptoms that vary from person to person. Most get a rapid pulse, nausea, some vomit, some need to nap. Duodenal Switch: This completely cuts out a portion of the stomach and leaves a larger stomach than the RNY - typically about 6 ounces. There is a large bypass on the intestine which causes malabsorption of calories and some nutrients. This is a riskier surgery, but the benefits are that you don't experience dumping syndrome and you can eat more calories without absorbing them all. If you are a food lover it can get you into trouble though as I have seen with a few who have had the DS. You can eat a little more and you don't have the aversion to high calorie high carb foods, so you can get complacent in keeping up on it. It's still work, and some folks with the DS delude themselves into thinking they got the free ride out of all of them. Lap Band: This is the least invasive of the surgeries where a band is placed around the top portion of the stomach causing a pouch to form. There is no bypass of the intestine so there is malabsorption. This is a good thing as problems with vitamin absorption is almost eliminated. It also takes less time to perform the surgery. Drawbacks are that the weight loss is slower and like the DS you can eat pretty much what you like with little or no ill effects. This can be a problem for some people. You also cannot have this if you have a hiatal hernia as it will put pressure on it. Generally I think if you are a good dieter and don't mind doing some work and just want more restriction, this would be a fantastic option for many people. If you are a lousy dieter and need more aversion therapy, it might not be the best option. There are a few other different types of surgeries out there but I don't have time to go into details. Those are the basic 3. Good luck to you and I hope you are soon on your way to a new you! Dina

Talk to your own physician about a referral to OHSU. As a public institution they know the funding ropes. The surgeons and the staff are excellent! If you send me an email, I'll send you the head nurse's email and you can communicate directly with her. peace, tee

Well my "physician" is a nurse practitioner that I've only seen twice. I moved down here a year and a half ago so I don't know her very well (and actually dont' really care for her but I don't have much choice due to the insurance I'm on) I'm highly interested in the DS surgery, so far from what I read, from what I understand and from knowing myself and what might work best, this so far seems like the best option for me. I know there are a couple doctors at OHSU that do the DS surgery and as far as I know take Medicare. The interesting thing is my mom works there, she's only worked there a couple months though lol. I'm going to call next week and ask about insurance coverage and what the first steps I'm going to need to take are. That's a start I'm not sure what I would say to the head nurse? Do I ask her about coverage and what I need to do to get the ball rolling? I have no idea!! lol

Brianna, OHSU offers free seminars, quite often, that teach you all about WLS and even help with insurance questions. Call their division of general surgery at 503-494-8372 I believe. Ask when the next time Dr. Deveny is having a free WLS lecture. I went in at 429 on 11/23, and as of 1/7 I am 371, so it's working. I want to warn you however, you need to be very careful to follow directions, and have some form of support system at home afterwards. I chose the Rhoun Y because of the lower likelihood of malnutrition (DS is the highest chance of that). I had to have a second surgery to repair a leak the day they sent me home, and am still recovering from it, but feel good and am already eating solids. The Dr. that I used at OHSU is Clifford Deveny, and I highly recommend him. Best of luck, and if you have any questions just e-mail me at [email protected] Glenn (Formerly of Salem, now of Tualatin)

Hiya! We have a lot in common, check out my profile for what I have done so far, or my website www.groovythoughts.com and there is a link for WLS and my BLOG is my journal. I know exactly where you are coming from, I really do! If you ever need a pal, I am here, just email me, k? Brandi