What are the right questions to be asking?

While reading various forums, I learn a new question to ask my doctor every day!!!!  This concerns me......how do I know that I'm asking all the right questions prior to surgery?  How do I know that the doctors are being forthcoming with providing all the information (good and bad) associated with the various procedures?  If I'm not knowledgeable enough medically how do I know what I'm overlooking?  I keep reading and researching.  Sometimes the information becomes overwhelming and I get frustrated and almost want to say "forget it" but then I read a post about how WLS has made a tremendous impact on their weight loss journey. Help!!

A book that was a good guide for me was Weight Loss Surgery for Dummies. It really is a good book for beginning of the journey to recipes post-op. It helped me sort through all my questions.  I picked my surgery first and then went searching for a surgeon. I had to find a surgeon who did the surgery I had chosen and there aren't that many that do the duodenal switch.

I went to my surgeon's info session where he explained the pros and cons of each surgery. He did not try to sell surgeries. His presentation is unique from all I've gathered here. He helps you pick the surgery that will be the most likely to help you be successful for your eating challenges. He categorizes eaters into 3 types, bloaters (they eat large meals and very few snacks), sweeters (are addicted to sweets), and grazers (we eat a little bit of something all day long). Bloaters may do well with the sleeve or band (totally restrictive with no malabsorption). Sweeters may need some restriction and potential negative reinforcement of dumping, and the RNY may be enough. Grazers may need some restriction but really need the malabsorption of the DS to overcome all the little snacks.

As a lightweight, at the consult, I had to sell my surgeon's dietitian that I fit the DS requirements even though he thinks twice about giving a light weight a DS due to the greater malabsorption. The dietitian listened to me explain my eating habits and physical limitations for exercise and she helped me sell my surgeon that the DS was right for me. Best thing I've ever done for myself--ever.

--gina


 

Hmmmm...that's interesting about the three types of eaters.  I've never heard that before.  I would have to say that I am sweeter and sometimes a grazer who is looking at VSG.   I havent met with the nutritonist yet but perhaps she will shed some insight as to the procedure that might work best for me.

Someone in one of the posts mentioned hormones and nutrients!  I knew to ask about the nutrients that I would be losing with the VSG but didn't think about how it would affect my hormones!

Thanks for the referral on the book -- I will be purchasing it this weekend!!!  It'll be informative for myself as well as my husband -- who has many many questions.

The book I have doesn't have much on the VSG as a standalone surgery. I bought it in 2007 so look to see if it's been updated since then.

--gina

I think it's more complicated than those 3 types.

By those categories, I am a sweeter and a grazer and should have gotten either RnY or a DS. But the VSG was perfect for me. The malabsorption of the DS would have been too much and RnY would have driven me batty for a number of reasons.

This is becaues my main problem is that I had a voracious appetite. It was hunger that had me eating all day long. The VSG directly addresses this problem by removing the portion of the stomach that makes ghrelin. So now I have normal hunger and therefore no need to graze.

Also, without massive hunger driving me, it's a lot easier to avoid trouble foods and my sweet tooth has subsided quite a bit as a result. I actually find some foods to be too sweet now! OTOH, I know myself and I know dumping would not be a deterrent for me. I would be one of those people who pushes the line. I also HATE not being in control and the arbitrary nature of dumping freaks me out.

Finally, since the band and RnY don't remove the ghrelin (in fact, bandsters in one study had 2x as much ghrelin post-op as pre-op), I just felt like hunger control was too risky with them. I have a lot of bandster friends and enough of them never were able to find proper restriction and so didn't get the hunger control that WLS normally provides to scare me off from that surgery.

As for RnY, I keep seeing RnYers saying things like "and the hunger WILL come back" and also "I can eat a cup of food now" once they are more than 1 year out. I didn't like that either. With the VSG, you see less of that. I'm 2 years out with VSG and I can still only eat 4-6 oz. of food and my hunger is at the same levels it was at 6 months out and that seems the more common VSG experience.

The thing to keep in mind about all of this though is, yes, some surgeries will work better for you with your personality and your values and your health issue than others but they *all* can work if you work them. The other thing is that the VSG is not a standard surgery right now so not all VSGs are equal.

As an example, many surgeons find their VSG patients are losing as much as their RnY patients. But many surgeons are finding they lose slightly less. So it's important to know what your surgeon's stats are and how he does the VSG, if that's the one you want to get. You also have to be comfortable that the procedure hasn't been done for decades (at least not as a stand-alone WLS procedure) and not everyone is.

I learned the most at my support group. I started going twice a month starting in January. After the meeting is over, groups of us usually hang behind and get all of my questions answered :)

I felt so comfortable that by the time I meet my surgeon, I hardly had anything to ask him at all. He saw I had a 2 inch binder with me full of information so he figured I knew more than most...

research, research, research!

Good luck on your journey!!!