WLS's candidates, failures - revisions - Please don't 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
There is something wrong with your post, you make it sound like you are against ALL wls (including DS) most of the time, which is going to put people of of reading.
I wassupposed to have a two-step DS, but I'm doubting getting the second step. (I have a vsg now) I just can't get the protein in. I never liked meat etc, and forcing it all in is worse then being on a diet.:(
If you could send me a link to the 'diets don't work'study, I'd be so grateful, I was looking for it the other day, but couldn't find.
I wassupposed to have a two-step DS, but I'm doubting getting the second step. (I have a vsg now) I just can't get the protein in. I never liked meat etc, and forcing it all in is worse then being on a diet.:(
If you could send me a link to the 'diets don't work'study, I'd be so grateful, I was looking for it the other day, but couldn't find.
HW: 115 SW:109 GW:68
You need a link to the "diets don't work" study? Really? An official study? Look at how many overweight people there are. Plus, if diets DO work, why did you get VSG sugery? Couldn't you have just dieted and lost the weight? I guess I am just bitter because I have been dieting practically my whole life, got the lap band, still dieted, and still weigh 270 pounds. I'm currently seeking a DS revision and hope one day I will get it and finally be successful at this dieting thing.
Ann-Marie
Ann-Marie
Get of your high horse! I said I was looking for the study myself! This is just to prove to my not-ever-been overweight friends that diets don't work. They think we just never tried, so I wanted a real study to back me up. I know that not long ago there was a study that proved that people on a diet actually gain weight later, do you have any idea how rare it is to have this information to back you up?
I didn't say anyting wrong, and I have no idea why you felt the need to talk to me like that.
Good luck with your DS!
I didn't say anyting wrong, and I have no idea why you felt the need to talk to me like that.
Good luck with your DS!
HW: 115 SW:109 GW:68
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