Revisions & Thoughts

I don't know if anyone else lurks on the DS board or Revision forum, but over the  last few months there seem to be a number of 'failed' VSG patients inquiring about revisions to full DS.  I guess this is an inevitable consequence of the up-swing in popularity of VSG and the wider variety of surgeons performing the procedure along with differing eating and support programs. 

I'm a firm believer that you can learn as much if not more from those who 'fail' as from those who are a 'success,' and I'm keeping my eye out for recurring themes.  it's interesting to see the "I didn't get to goal but did everything right" rationale from folks I've never seen post to the VSG board and have surgeons/program I've never seen discussed.  It begs the question as to whether or not they were set up for failure from the start.

Wow--we are all real glad you are lurking over there. Keep us posted on the latest reasons for failure. I agree, we have to be as alert, maybe more alert, to those that fail, as those that succeed. I wonder if their Ghrelin comes back in full force?? The other day I had a 1,700 calorie day--ate like pre-VSG--could not get enough protein in--but needless to say, it scared me as I do not want to slip back into my old patterns. Plus the hunger was pretty ferocious. I am back to basics now and my hunger is much diminished, but we all know, it gets harder the further along one gets. Thanx for sharing.

I had a day like that yesterday, but I also have noticed what I think is the beginning of some reflux -- that kind of hungry, burny sensation plus a bit of a sore throat and a cough.

I called my surgeon's office, and  I'm starting a PPI tomorrow.

Ive seen a handful of people (whom ive mostly blocked at this point) who SELECT the VSG because they want to "keep the option open" of having the DS *if* they fail. I usually seem them posting around 2-3 months and then again around 6 months about how their VSG is failing them and they are considering the DS. To me, people have no faith in themselves from the beginning so in a way, they are setting themselves up to fail.

Just yesterday, I spent almost two hours talking to two people on the phone who's surgeon's make much bigger sleeve's and use the very liberal 1200 calorie, eat anything you like, diet.  In both instances I think I made them think about using a different program, (they are both pre-op).  I am hoping that I am doing my little bit to keep these people of the revision board.  Sigh.

Thank you for all the service you do.

I guess my perspective on this is a little different. I wish that more people would seriously consider the DS to begin with because it is far more forgiving that the vsg, has great stats, and resolves diabetes. Not for everyone, certainly, but worth at least considering, as I did, long and hard. People get scared about the malabsorption, and it is absolutely nothing to fool around with, but for some people, I believe it's necessary. To me, the people who post here with questionable eating programs and the mentality that the surgery is going to do the work for them have been done a HUGE disservice by their surgeon, and that really irks me. They are, as you say, set up for failure from the start.

Going to a surgeon that does both surgeries can really help someone to make an informed choice after really making an honest assessment of where they are physically and mentally. Unfortunately, there are far more surgeons who are doing the vsg now because it's an easier surgery. I remember Dr. Jossart told me that as a very general rule, he believes the vsg is great for those with BMI's 45 and under. Above 50 and for those with diabetes, he believes the DS might be the better route. Again, this is a generalization as we have many with high BMIs who have been successful. But I think too many people never really consider the DS because they don't have access to a top notch surgeon who does all the weight loss surgeries. Makes me sad...

Lizanne

I don't disagree with you at all. I think DS is probably a better choice than VSG for a lot of patients, particularly those with long-standing diabetes. VSG, however, is a more profitable surgery for surgeons, and there's less risk involved for the surgeon. I think that's part of the reason so many shy away from DS and push patients toward VSG who would be better off with DS.

One point my surgeon has made is that he no longer does DS (which was his main practice) because he achieves the same weightloss results with VSG patients in the program he has, now, without some of the risk. With VSG, non-compliance means inadequate weightloss in most cases. With DS, it can mean patients brought in on a gurney. My surgeon's nurse was telling me about patients crippled by severe vitamin deficiencies and resulting nerve damage being brought in to the office in wheel chairs, for example.

Yes, the risks are definitely greater, that's for sure. Knowing I would have to take SO many supplements was a deal breaker for me personally, though the people I know with the DS are all doing well and are healthy. But you really need to be on top of it for sure. And the DS, even more than the vsg, is non standardized. I know that Dr. Jossart, for one, makes the stomachs very small, like ours, but uses a longer common channel so that there is not as much malabsorbtion and fewer bowel issues, like gas, etc. That is one surgery I would certainly not trust to a surgeon who hadn't done a bunch! And I agree--I don't think the DS will EVER be a main stream WLS because of the complexity and risks to both patients and doctors...

L.

 My Kaiser flat out does not do the DS though recently I see that they did refer someone to a SF surgeon because of her high BMI.   Because they didn't perform the DS I never researched it.  I wasn't a candidate for RNY because of chemo type drugs and family history of Celiac Sprue, so I honestly thought my only option was the VSG.  at the time, I was on VSGtalk forums.  USA Armywife (Tiffy) helped me understand the benefits of VSG.

I'm really glad I didn't know anything about "failed VSG" as even a possibility because it meant that my only course was to succeed.  When my weight loss wa at a snail's crawl, I just had to work harder.  Brandilynn just kept emailing me that maintenance would be easier because I had a good foundation.  I trusted her and she was right.

I spent my first year post op on the Lightweight Forum here on OH. There were not many VSG's on that forum at the time.  I missed a lot of bad information on the VSG board, but I also missed a lot of wisdom.  I wish I had gotten the shared wisdom of those ahead of me.

we all take a different path to get where we are going.  From the beginning I've said, let's meet up in 5 years, 10 years and then see what factors into success.  I don't think success really gets measured out until those later years happen, when life is back to normal with many of the challenges we faced pre op returning.

Here's to us all succeeding!