Question:
Am I doing the right thing?
I see all of the weight loss ads on TV and most of the time I find myself crying. If they can lose all of their weight by taking a pill and eating special meals prepared just for you, then why can't I just stop overeating everytime I turn around? Then I remember that most of them are paid celebrities and can afford to buy the expensive systems and hire a personal trainer. We are just the average to low income people and most of us are fortunate to have health insurance that cares enough about us to allow us this "luxury," whether you think of it as that or not. We are all taking a great chance with our lives by having this surgery done. There is a great deal of risk we are taking when we go ahead and have this surgery, no matter which type of surgery is done. Hopefully, the decision to have the surgery by each and every one of us, is for ourselves. I want to be around for all of our grandchildren as long as I possibly can, but with the way things are going now, every bite I take is one step closer to death. I suffer from obesity, diabetes II, high blood pressure, high cholesterol, depression, hypothyroidism, fibromyalgia, short term memory loss on occassion and am only 44 years old. I have had most of these problems for 10 years as of July this year. Our health, family, and friends are also a big factor in the decision. I struggle almost everyday, with the decisions I make about food. Our family is falling apart and I have a great deal of personal/family matters on my plate. I am going through depression right now and frustration with five of our six children, who continuously are making bad decisions. My husband (who has COPD) just starting smoking again as well as our 18 year old daughter and we have another daughter in the house that smokes. You don't know how bad I want to smoke a cigerette. I went outdoors the other day to find out where everyone was at. Guess what? There were five people in our backyard having a "smoking party." I came in the house, went to my office, and just started to cry, just like I am know doing while writing this. I want to smoke really bad, but know if I do, it really will be the wrong thing and I am not great on willpower. I really don't know what is keeping me from smoking at this time, but maybe it is God. I just wish I could refrain from eating, like I can with smoking. I do not have a surgery date as yet, but have completed all of the pre-op neccessities, except for one more pysch appt on 06/20. According to my insurance, I have until August to get the surgery completed before my approval runs out. I am going to have the lapband surgery done by Dr. Sudan in Omaha, NE. I am getting scared about all of this, but at the same time I am hoping that I have made the right decision. I have good days and bad days when it comes to eating and know that I will have to make a severe lifestyle change after the surgery. I have days that I could care less about what I eat and eat whatever I feel like eating. I had lost about 15 pounds over about a month, but then gained most of it back. Exercise is really hard for me to do. I suffered a severe back injury in January 2007 and ruptured 4 discs in my lower back and according to the neurosurgeon, surgery would probably not help this as they can only fuse two discs at this time. This prevents me from exercising like I should as the increased activity sends excrutiating pain down my legs or irriates my back. I haven't found any exercise that works for me. I was doing 200 crunches a day, but that really sent my back in an uproar and ended up missing work because of it. I am know down to doing 10 reps in the morning and 10 reps in the evening and can do that without a whole lot of pain. Walking any long distances causes great pain in my lower back, hips, and legs. I usually try to walk about 12 blocks a couple times a week and that's about all I can handle. I just need to know that there is someone else out there that maybe having second thoughts or frustrations or confusion. I guess I just feel like I am a basket case and not sure if I will be able to go through with this surgery. Our insurance will pay for all of the cost as we have met our deductible for the year, so that is not the issue at all. I am really lucky that we have very good insurance. — mrsj4ata (posted on June 6, 2008)
June 6, 2008
You know, it's such a personal decision that no one can tell you if you're
doing the right thing or not. My surgery is set for July 11th, so I can't
give you support from the post op perspective but I can from the pre-op
perspective. All I can say is that you are going to feel soooo much better
after you've lost some weight. I have struggled with my weight all my life
and this is the right decision, even though I'm a little scared, in my
heart I know it's right. I'll be happier after! Try to go to some support
group meetings, that will make you feel at ease. They helped me! Good
Luck!
— Kar708
June 6, 2008
My heart goes out to you..I can feel your pain and confusion and your sense
of helplessness and hopelessness but dont give up..I was there..right where
you are, before and after the surgery..it is a part of life but having the
surgery helped me deal with alot of my medical issues.I was on 9 different
medications had numerous health problems...all corrected by the surgery and
I do not regret it one minute.I had to learn to love me and take care of me
first and foremost. Let them have a smoking party..you cant add it to your
already too full plate..smoking you can do without, but remember..food is a
necessity in life.We cant choose NOT to eat..we have to eat.But we can make
healthy choices about what we eat.I stumble and I struggle EVERYDAY..am an
alcoholic..am 37 an just had a wonderful baby boy and two lovely daughters
that looked up to me with pride and I have managed to crush their idea of
how great I was..just by drinking...I struggle everyday not to drink..this
has been going on for a year..an I usually feel like a failure but I give
myself credit for the good things I do for myself and you should too..some
days you will eat down the house..ok..it was a ruff day, brush yourself off
and start again the next day..never quit trying..if you quit trying..you
start dying.My sister died at 718lbs because she gave up and quit
trying..we dont have to do that.i feel I have failed because I have gained
back weight post op, but that is why am here..for support from all of you
and to continue trying. Honey, I hope that all the positive feedback you
get on this site will lift your spirits as it do mine..we all have our
battles, personal, financial and emotional..but we also all have each
other..
— caymanbabe
June 6, 2008
Teresa,
First of all those people on Biggest loser and other clerbrities that you
see are not you and me. We have real issues, and at 62 I have tried
everything they have. I only failed at one thing in my life that I wanted
to do and that was lose weight the normal way. Guess what, there is no
normal way. Your are lucky that your insurance pays for the surgery.
Mined after two years gave me approval, and my doctor changed hospitals, so
I got re-approval, and they took the opportunity to decline me. I sued
them and lost! I had to pay cash. You got insurance that is going to pay
so thank God, you have that option. Now God help those who help them
selves. You have posted so many iussues I would have to write a reply
twice as long as your inquire to answer everything. Let's start with this.
Tonight go have a pain on your right side and you go to the hospital and
they tell you you have to have your appendex out or you will be dead by
morning. Are you going to think about it. Is my co-pay been ment for the
year? Do I have the surgery or should I just go home and die? Dumb
question, but RNY and Lab Band WLS is no different. It is the same cut and
they are working in the same area. There is the same risk. No you are not
going to die today from being overweight. But have you been to an old
folks home lately? I have, and you know what I noticed. There are no
overweight people there. DId they go there fat and get put on a diet that
works? No all the fat ones are dead! So, you and I are risking our life
and the opportunity to see your childeren get married, and see your
grandkids, and see your grand kids graduate and get married and maybe a few
of them will have great grandkids you could have seen, if you just go
signed up on this life saving program and started today to turn your life
arond with Gods help and support, and the support of your family and
freinds. I have to be so direct, but some one needs to help you see the
light. 8 weeks after surgery you will not beleive you questioned doing it,
but we have all been where you are. Now, real quick, I need to tell you I
had type two Diabities for 25 years, I took insulin and 19 drugs for high
blood pressure, high colestrol and diabities. Did those drugs cure it?
No, and if it was not for this surgery, and I am glad to tell you more of
how RNY WLS will cure these issues for you as it did for me, but you need
to write me off line, as I miss my spell checker for these longer messages.
I can tell you that after 1 month, I did not take insulin and I only took
one of the 19 drugs, Syntroid for thyroid which surgery will not cure. No
big deal, I am a happy camper. First of all with depression before, you
might not get past the nut doctor that has to pass on you, so get to your
family doctor and get him to give you the generaice drug for Lexapro or
something to help you before you take that step. There is often depression
following the surgery, and it happens to all of us on diets. The weight
loss changes your chemical balance and depression is common. The other
issue is that you have an addition and giving up one can cause others, so
that is why they check you out so much up front. THis is not just cut and
you lose, you have to work at it, but the nice thing is cheating can make
you sick and if you get sick once, you most likely will not do that again.
I was 6 months yesterday, and I have lost over 100 Lbs. I am very happy,
glad that I gave up trying to cure myself with diets that did not work, and
glad that my cardatoligest told me I was the oldest fat patient he had, as
the other guy, age 66 dies last week. Hard to hear, but he also wrote a
recomendation for me for the surgery, and I ready it before handing it to
my surgeon. He said there was a lot of risk I could go to sleep for
surgery and not wake up, but he also said that he expected without the
surgery, I had 3-4 more years before I passed. At first glance I though
Pass way, and then it hit me. He ment I was going to die. I started being
able after surger to walk a block, and this sunday I will do my third 10
mile walk on the beach. The first time, I finished last, the second time I
finished 9th out of 25 and this time, I hope to finish first! You can do
it, best of success to you. Send me your email addiress and sign on to
join my freinds as I am glad to help, any way that I can, but there were a
lot of people on the interent for me and I am glad to help those that I can
as well.
— William (Bill) wmil
June 6, 2008
I think it would help best if at this point and time in your life you
concentrate on your self. The rest of the family can smoke and eat or what
ever they want to do. Just take the next few months for yourself. If you
are like me it has been a long time since you have done this. Also if
there is a pool close by see if they have a time for exercise classes.
This is easier on your body and very relaxing to be in the water. Just a
thought. Hope all goes well and you get a date soon. The sooner you
began to change your life the sooner the people around you see that maybe
they should change also. If not know that you are doing the right thing
for you. Tina
— tinajohn
June 6, 2008
"Am I doing the right thing?" is a question that is asked by
everyone on this site and/or contemplating having life changing surgery.
Each of us has to answer that question for ourselves but I can tell you
that I, for one would have it no other way because my life has become so
much better for it.
Seeing people on TV doing it with pills etc. does NOT mean it's the right
way for you...or for everyone. The weight was not put on over night and
will not come off as such either.(It's been shown that people who lose the
weight through these methods tend to regain it and more because they really
don't take things seriously and still hold on to bad habits.) Even the
surgery is a TOOL to use to HELP get and keep the weight off. Even with the
surgery, it's a life style change but a great one. The surgery gives you a
starting point and a handle on will power, but the desire for CHANGE has to
come from within YOU.
As I said before, all of us here at Obesity Help are struggling with the
question of "AM I doing the right thing? Which surgery is best for me?
" and other questions. That's a healthy range of emotions to have.
You've taken the first steps, you'll do well and once you have the other
pysch eval. on 6/20 ( talk it through with the therapist) you'll find that
you're in a better place to really take that final step.
Having the surgery and watching the weight come off will be motivation in
itself. Another motivation will be feeling so much better and having more
freedom of movement then you've ever imagined. You'll be able to accomplish
things you once though impossible.
You aren't going through this alone. You have a whole family here at
Obesity Help that is ready and willing to give support to this important
journey in your life.
— Leprechaun
June 6, 2008
Teresa, I understand, but you have to concentrate on yourself. I hear you
about the celebrities and their diet, but look at what they have at their
finger tips and look at them after the weight loss, most gain back...The
exercising I do because of metal rods and screws in my back and two knee
replacements, diabetes, high blood pressure,I am bipolar, depression, heart
disease and some other stuff, is water aerobics and that works great. I
had lap band 4-16-08 and that is the surgery for me. I wanted gastric
bypass but couldn't have it because when they did the testing on me they
found a Pulomarny Embolism and my cardiologist said no but I am happy with
the lap band..I have lost 30 pounds and I am feeling better. All of us
around OH has a food addiction and that is what we are taking care of now,
you are not alone. Sometimes now, I think, can I do this and I answer
myself yes I can and the band helps me. It is a lifestyle change and you
can do it..Doubting yourself is there sometimes and when you have it, you
think this is great...look what I have done because I am feeling so good...
Good Luck, whatever you decide.
— dyates2948
June 6, 2008
I feel your pain and I agree with alot of the others. Worry about you first
this time! Everything else will fall into place and worrying isn't going to
solve anything except elevate your blood pressure and so on. My advice is
to speak with a counselor or therapist about your concerns. This will help
ALOT! Food is an addiction and may have been a trade off for the smoking.
So when the ability to satisfy yourself with food is gone, it may be
something else that replaces it. (Drinking, smoking, gambling, shopping or
sometimes sex) So find out what is "driving" you and how to
"Kick it's Butt" before it drives you crazy with confusion. I had
surgery February of 2007 and am still discovering myself, BUT very happy
with the decision to have the surgery. Good Luck and KNOW we are always
here for you!!!
— Toni Todd
June 6, 2008
God bless. I can hear so much fear in your message. Try not to be so
hard on yourself. Please understand that surgery of any kind can put you
at risk for complications. I don't believe wls can put you in any more
danger than another major operation. I'm concerned yes. However, I put my
trust and faith in GOD, because I truly believe that doctors get their
wisdom and knowledge from GOD and He can direct us to the right medical
procedure. You have the wisdom to research the different procedures, now
use your gut feelings and go with what you know is right. If we had all
the will-power, then where is the need to pray or reach out to other people
for help, and to ask GOD's guidance in our life. Thank GOD giving you the
mind to have this surgery, insurance to pay, and this website to encourage
you. There are alot of people who want this procedure, but can't afford to
pay for it. It is time to stop looking at other people and what they are
doing, worry about yourself. Use this tool that GOD's has provided for us.
Go forward--don't look back.
— Toby2
June 6, 2008
Teresa:
First, you are correct in saying that the paid celebrities have HELP in
losing the weight and thus have an advantage. They are also usually NOT as
severely overweight as the average American. I am, or WAS in a similar
situation to you. I too, have a bad back. It is not as bad as yours. I
also suffer from fibromyalgia, diabetes, depression, and hypothyroidism. I
also suffer from severe migraines, arthritis, a spastic colon and chronic
diarrhea. I have had the Vertical Sleeve Gastrectomy on March 1, 2008. In
the time since then I have lost over 65 pounds and have had MANY of my
symptoms have been either completely eliminated or severely reduced. The
ONLY side effects have been POSITIVE! I have had to DROP all of my
diabetes meds! I was taking 70 to 80 units of 70/30 Humulin a day with an
occasional booster of REGULAR insulin, sometimes up to 5 units of the
regular insulin, to keep my blood sugar level BELOW 200! I was also taking
4 pills of glucovance 5/500 a day. In 3 WEEKS I had dropped EVERYTHING but
ONE PILL of glucovance! On Easter Day, I went to church with my family and
AFTERWARD we went out with some of our CHURCH family and had a Barbecue.
After the Barbecue, we came home and I started to get the shakes and the
sweats. I KNEW those symptoms from when I was HYPOGLYCEMIC before I became
a diabetic! My Blood Sugar was too low! I took out my testing kit and
checked my blood sugar and sure enough it read at 53 points! Low NORMAL is
70! I quickly got something sweet to eat (some fruit) and got my blood
sugar back up into normal range. At that time I realized that I would have
to forgo the LAST pill of glucovance because it was TOO MUCH MEDICATION! I
ran the risk of putting myself into a diabetic COMA if I kept taking the
pills! My wife is a Nurse Practitioner and had been advising me on my
medication levels during my whole transition. My needs had been changing
so quickly that my physician would not have been able to keep up with the
changes at the rate things were changing. To get an appointment would take
longer than most of the changes were taking. I have not used any diabetes
medication since that day. I have been keeping an eye on my blood sugars
and as long as I stick with the recommended diet and don't cheat. As long
as I stay away from refined sugars and refined wheat products and eat my
proteins first, my blood sugar levels stay between 114 to 140 after meals.
This is MUCH better than the OVER 200 that I was having BEFORE the surgery!
I have also had improvements with my Arthritis (almost completely GONE), my
FibroMyalgia (the pain is significantly reduced), my Migraines (the pain
and frequency have been both reduced), my Spastic Colon (it seems to have
been completely calmed), my Chronic Diarrhea (also completely
eliminated--it was probably tied to the Spastic Colon), and my Chronic
Fatigue (I have significantly MORE energy than I did before). The VSG has
been the THIRD best thing that has ever happened to me in my LIFE! The
FIRST was my MARRIAGE (I must give the CREDIT for the surgery to my WIFE,
it was HER idea). The SECOND best thing that has ever happened to me was
the birth of my CHILDREN! The VSG comes in a close third.
I am including some research that I have done on the various types of
weight loss surgery available. I feel it is VERY important for a person to
be FULLY informed of their options when looking at weight loss surgery.
Take this for what it's worth. I am telling you up front that I am NOT an
"Expert" on Weight Loss Surgery. I am just a PATIENT that has
done some research. I encourage EVERYONE to RESEARCH EACH surgical option
FOR THEMSELVES! THIS is the information that I have found in MY research.
I have posted it here for you in an effort to help GUIDE and you help you
START your OWN journey into your OWN research.
There are a LOT of differences in the different types of surgical
procedures. There are a LOT of differences in different SURGEONS. Some
surgeons require more of their patients than others. Some PROCEDURES
require more of the patient than others. You need to do some research and
find the BEST fit for YOU. I just had a Vertical Sleeve Gastrectomy on
March 1, 2008. My surgeon did NOT require me to lose weight. I had a BMI
of 43.6. Now that isn't NEARLY as bad as many people. Had I been HEAVIER,
he may HAVE required it. I don't know. What I CAN tell you is that I was
having problems with arthritis in my knees and my shoulder. That was
almost three months ago. Now it is GONE. There is just a TWINGE every now
and again but NOTHING NEAR the constant agony that I was in before! I was
also a Diabetic 3 months ago. I have had to DROP all of my diabetes
medications on Easter Day because the ONE glucovance pill that I was taking
caused me to have my blood sugar to DROP to 53 POINTS! My sugars are still
a LITTLE high, but under 150 (usually between 114 to 140 after a meal) and
WITHOUT medication! In a FEW weeks with some MORE weight loss, I figure
that my diabetes will be in COMPLETE remission! I have lost 59 pounds in a
little over 2 MONTHS with my surgery (the VSG) and it was done WITHOUT
feeling HUNGRY!
From what I have learned, your MAIN options are the Lap Band, the Vertical
Banded Gastroplasty, the Gastric Bypass, The Duodenal Switch and the
Vertical Sleeve Gastrectomy. There are other options, I am sure, but these
are the most common that I have found. There are also combinations of
these options ALSO available such as the Banded Duodenal Switch, the Banded
Gastric Bypass, and the Banded Sleeve Gastrectomy. The Banded options are
basically the same as the Regular surgeries but they have a Lap Band added
as additional insurance in case of future need.
The Lap Band: (http://www.obesityhelp.com/content/wlsurgery.html#LapBand)
is well known. It basically squeezes the stomach to make it smaller and
creates a pouch with a restriction at the top of the stomach which fills
quickly and empties slowly. The advantages of this surgery are that it is
reversible if needed and it is adjustable if needed. It is a HIGHLY
flexible procedure. This surgery is well known and accepted by many
insurance companies. It may be best for people who have a history of
cancer either themselves or in their family and may need to take
chemo-therapy and for women in childbearing years who may become pregnant.
There are also other reasons for wanting this type of surgery, but I don't
want to spend ALL day writing this. There is an effective Excess body
weight loss over 3 to 5 years of 50% to 60% noted in some studies. The
PROBLEM with this option is that there are sometimes complications with
this device. Some people have a reaction to the foreign object in their
body. People with immune issues should NOT have this device. Lupus and MS
patients for example, can have a reaction to the foreign body and it may
trigger an immune system response. Other issues with the Lap Band are that
it is common for the band to "Slip" on the stomach and cause the
pouch to enlarge thus causing the person with the device to eat more and
negating the purpose of the surgery. Some surgeons have started stitching
the band to the stomach to prevent this from happening. It would be wise
to ask your surgeon if you are considering this option if he does this.
Other times people have learned to "Eat around the Band" and
force the food PAST the band to fill up the rest of the stomach and thus
defeat the purpose of the band. Actually, this is an issue with ALL weight
loss surgeries. All can be defeated by a patient who is either ignorant or
intent on doing so. It seems to be MORE common with the Banded options,
however. Another issue with Banded options is that occasionally the bands
will erode the outside lining of the stomach causing damage to the stomach
that often needs repairs and calls for a removal of the band and or a
revision to some other type of weight loss option. This happens in about
less than 1% of the Lap Band Surgeries but it IS something that needs to be
taken into consideration.
In the Vertical Banded Gastroplasty:
(http://www.obesityhelp.com/content/wlsurgery.html#VBG) (commonly known as
stomach stapling) the surgeon makes a cut into the stomach to create a
pouch. He sews the pouch and places a band at the bottom of the pouch.
This banded option has less chance of the band slipping since the cut in
the stomach holds it into place. It also has the advantage of being
somewhat reversible but is not as easily reversible as the Lap Band. It is
NOT as well known as it's more famous banded cousin, the Lap Band. There
may be difficulties in getting this option with some insurance companies.
It has many of the advantages and disadvantages of the Lap Band surgery
with the exception that the Band does not tend to slip and let the pouch
expand.
The Gastric Bypass: (
http://www.obesityhelp.com/content/wlsurgery.html#RNY) is made when the
surgeon cuts the TOP of the stomach off and creates a pouch. An OLDER
version of this surgery left the stomach intact but had a line of staples
that was used to create the pouch. This method is no longer in use much,
if at all. The surgeon then takes a length of intestine and BYPASSES it.
He takes the LOOSE end that is still attached to the intestines and sews it
to the SIDE of the pouch that was created from the TOP of the stomach. The
BYPASSED intestine is then attached to the side of the intestine that was
connected to the pouch so that BILE from the bile duct can empty bile from
the liver into the intestine. This option is often the DARLING of
insurance companies. Many companies that won't pay for any OTHER Weight
Loss Surgeries will pay for THIS one. THAT makes THIS surgery quite
popular for many surgeons! This surgery has the advantage of being a
HIGHLY effective tool in the arsenal of weapons against the foe obesity!
It has an effective rate of weight loss and maintenance of 60 to 80% in
some studies at 1 to 2 years. The DOWNSIDE of this weight loss option is
that there issues of malabsorption of minerals and vitamins due to the
bypassed intestine. This often leaves the patient reliant on his doctor
for the special supplements required to maintain his or her health. Other
issues are dumping, nausea, and vomiting. Dumping is basically when you
have diarrhea that is caused by the intestine's inability to absorb the
food that was eaten. Along with the diarrhea can come intestinal cramping,
sweating, palpitations and other unpleasant side effects. Some people
experience dumping with sweets. Others experience it with fats. Each
person seems to have their own issues but whatever they are, they cause
them to excrete the food that they ate before it was fully digested.
Nausea and vomiting, while experienced by many in ALL weight loss surgeries
is NOT experienced by ALL. It does seem to be MORE PREVALENT in the
GASTRIC BYPASS and DUODENAL SWITCH patients according to the research that
I have seen. The gas and foul smelling stool are also a result of the
shortened digestive process due to the bypassed intestine in both the
Gastric Bypass and the Duodenal Switch. There is also something called the
"Mini Gastric Bypass" This was quite popular a while back but
there where problems that were soon discovered that KEPT the procedure from
becoming a popular option. You can read MORE about this procedure at this
location:
http://ezinearticles.com/?Mini-Gastric-Bypass---The-Ideal-Weight-Loss-Solution&id=361143
.
This is a direct copy of the entry for the post on the Mini Gastric Bypass
in the section defining the procedure under the Variations of the Gastric
Bypass in WikiPedia. The quote begins here: "Loop Gastric bypass
("Mini-gastric bypass"): The first use of the gastric bypass, in
1967, used a loop of small bowel for re-construction, rather than a
Y-construction as is prevalent today. Although simpler to create, this
approach allowed bile and pancreatic enzymes from the small bowel to enter
the esophagus, sometimes causing severe inflammation and ulceration of
either the stomach or the lower esophagus. If a leak into the abdomen
occurs, this corrosive fluid can cause severe consequences. Numerous
studies show the loop reconstruction (Billroth II gastrojejunostomy) works
more safely when placed low on the stomach, but can be a disaster when
placed adjacent to the esophagus. Thus even today thousands of
"loops" are used for general surgical procedures such as ulcer
surgery, stomach cancer and injury to the stomach, but bariatric surgeons
abandoned use of the construction in the 1970s, when it was recognized that
its risk is not justified for weight management.
The Mini-Gastric Bypass, which uses the loop reconstruction, has been
suggested as an alternative to the Roux en-Y procedure, due to the
simplicity of its construction, which reduced the challenge of laparoscopic
surgery. It is claimed that construction of a long tubular gastric pouch
reduces the risk of inflammatory complications, and renders it as safe as
the RNY technique." While it has been CLAIMED that the change to a
longer tubular Gastric pouch reduces the risk of inflammatory
complications, there is little research that PROVES it. If you are
interested in having this procedure done, keep this in mind. The entry for
Gastric Bypass in WikiPedia can be found here:
http://en.wikipedia.org/wiki/Gastric_bypass_surgery . Here is a short
animation that shows what is done for the Mini Gastric Bypass:
http://www.youtube.com/watch?v=OFQPLF9IjtI .
The Duodenal Switch: (http://www.obesityhelp.com/content/wlsurgery.html#DS
) is the STRONGEST tool in this arsenal of weapons! Many surgeons think it
shouldn't be used lightly and often only recommend the procedure for people
with a body mass index OVER 50! In the Duodenal Switch, the surgeon
REMOVES approximately 85% of the stomach including MOST of the region of
the stomach that produces the hormone grehlin. Grehlin is one of the
hormones that create HUNGER. Removing the section of the stomach that
creates hunger is a HUGE feature of this procedure. The surgeons then sew
the rest of the stomach back together and create a tube shaped stomach that
resists stretching. The stomach varies in size depending on the surgeon
and the patient but can be anywhere from 2 ounces to 6 ounces, perhaps
more. The next step of this procedure involves bypassing the intestine
just like in the Gastric Bypass. Instead of attaching the intestine to the
SIDE of the stomach, it is attached to the BOTTOM of the stomach where the
intestine used to exit. The bypassed intestine is then sewn at one end
near the liver and the far end of the intestine is sewn to the intestine
that was attached to the stomach to pass bile to the intestines as it does
in the gastric bypass. This procedure is MORE efficient than the Gastric
Bypass in losing weight. This option has an effective rate of weight loss
and maintenance of 70 to 90% in those same studies. The downside when
compared to the Gastric Bypass is that Insurance companies often do not
know of this option and are often reluctant to pay for it. This option has
many of the same issues as the Gastric Bypass. There are some severe
malabsorption issues. There are often issues with dumping, nausea,
vomiting, GERD (acid reflux), gas and foul smelling stools. Many surgeons
have been reluctant to perform this surgery due to the severity of the
complications that can arise. This is why it is often reserved for those
who are considered severely morbidly obese. Many surgeons had looked for
an alternative to this surgery which lead to what was initially considered
a "Half Duodenal Switch" or as it later became known, the
"Vertical Sleeve Gastrectomy."
The Vertical Sleeve Gastrectomy:
(http://www.obesityhelp.com/content/wlsurgery.html#VSG) (if you get the
same picture as the Vertical Banded Gastroplasty, just scroll UP) is a
GREAT tool to use in the fight against obesity. While not QUITE as
effective as the Duodenal Switch, it is often JUST as effective as the
Gastric Bypass without the severity of the side effects of EITHER of those
two options. The Vertical Sleeve Gastrectomy initially started as an
attempt to create a safer Duodenal Switch alternative. While early
attempts were not as successful in weight loss reduction, this was mainly
due to the fact that the surgeons were relying on the larger size stomach
often used for the Duodenal Switch patients who often rely on the
"Switch" part of the surgery for some of the weight loss. Once
the surgeons started reducing the size of the STOMACH, the Vertical Sleeve
Gastrectomy became a much more effective tool at helping the patient loose
weight. In the Vertical Sleeve Gastrectomy, the stomach is cut and
approximately 85% of it is removed. Just like the Duodenal Switch, most of
the cells that produce the hormone grehlin are removed. This eliminates
most of the hunger that the patient used to have, if not all of it. The
stomach that is made from what is left is turned into a tube that is
resistant to stretching. This tube is often designed to hold from 2 to 4
ounces of food or liquid. At this point the surgery is complete. The
surgeons just need to close up and the patient needs to recover. The
upside to this surgery is that it is simple and has one of the LOWEST rates
of complications of all the weight loss surgeries. It also has one of the
HIGHEST rates of excess weight loss with one study in California coming in
starting at 58% to 77.9% loss in a ONE to TWO year study and one doctor in
England reporting that 100% of his patients had a weight loss and
maintenance OVER 70% at 6 YEARS of living with the Sleeve. He also
reported that patients with hypertension, diabetes, impaired glucose
tolerance, obstructive sleep apnea, asthma, or arthritis were all cured or
improved after surgery. It has also been said that this is the ONLY
recommended option for people with immune system problems. People with
diseases like Lupus or MS can have this procedure because there is NO
foreign object placed in their body. This also is one of the few
recommended options for people with organ transplants. People with
transplants need their intestines to metabolize their anti rejection
medications. There are possible issues with GERD in this surgery as there
are with the Duodenal Switch There are NO malabsorption issues with this
surgery. There are NO additional foul odors. There is NO additional
intestinal gas. While nausea and vomiting is common in ALL weight loss
surgeries, it is NO MORE PREVALENT in the Vertical Sleeve Gastrectomy than
in most of the other options. If needed, the Vertical Sleeve Gastrectomy
can be easily converted to a Duodenal Switch should additional Weight Loss
measures need to be taken at a later date. This act is called a
"Revision." Having your Vertical Sleeve Gastrectomy converted to
a Duodenal Switch would be said to be having a, "Revision of your
Vertical Sleeve Gastrectomy to a Duodenal Switch."
The Biggest DOWNSIDE to the Vertical Sleeve Gastrectomy is that it is
considered "Experimental" by many insurance companies. While it
has not been practiced HERE in the US as a weight loss option for very long
(about 5 years or so) it has been done for QUITE a while in Central and
South America and in Europe for quite some time. The surgery has been used
HERE in the US for OTHER reasons for QUITE a while. It has been used QUITE
effectively to treat stomach cancers and ulcers with good effect. These
treatments have been done in the US for quite some time.
There is a NEW option that is being explored for people that have had the
RNY that may be expanded to include OTHER weight loss surgical options and
possibly be used to REPLACE them in the future if it becomes approved for
that use. This new option is called stomaphyX. The stomaphyX surgery
basically takes a post down the INSIDE of the stomach and then FOLDS the
stomach in upon ITSELF and makes the available volume INSIDE the stomach
SMALLER. There is NO CUTTING on the abdomen or anywhere ELSE. All of the
surgery is done through the esophagus. None of the stomach is removed or
cut. At the moment, from what I have been able to find according to MY
research, the device is only approved for use with Gastric Bypass patients
to help make their existing pouches smaller. Permission is being sought to
expand the device's use to other types of weight loss surgeries and for use
on patients that have NOT had weight loss surgery but to be used in PLACE
of traditional weight loss surgery. From what I have been able to find,
this device has not been approved for this use yet. To find out MORE about
this option go to this link:
http://www.themorbidme.com/2007/09/stomaphyx-incis.html .
Options for getting surgeries that are not paid for by insurance can be
found if you are persistent. You can sometimes petition the company and
get them to reconsider with a doctor's explanation. You can also self pay
or take out a loan. Many times, the surgeries are cheaper in Mexico or
other central or South American countries. Do some research to find your
options.
Not every surgery is going to be right for every person. Frankly, for ME,
if I were an obese male with a BMI under 50 (which I am) or an obese woman
NOT of child bearing age, I would choose the Vertical Sleeve Gastrectomy
(which I DID). If I were an obese male with a BMI OVER 50, I would get the
Duodenal Switch. If my insurance company would not COVER it, I would get
the Sleeve. If not THAT, then the Gastric Bypass. I would keep working my
way down the list until I found SOMETHING that I could get. If the
insurance company wouldn't pay, I would try to take out a LOAN (this is
actually what my wife did for me). If I were a WOMAN of child bearing
years or a person facing the possibility of chemotherapy or some other
health issues that would require periods when I would NEED more sustenance,
I would want the flexibility of the Lap Band. The short of it is, Do YOUR
RESEARCH and CHOOSE the right surgical option for YOU! If you can't get
ONE option for a reason, at least get another! For the sake of yourself
and the ones you love, do SOMETHING to fix the problem before it is too
late. If you die due to health problems caused by obesity, it is TOO LATE!
Whatever surgical option you choose, for whatever REASON you choose, we are
ALL here for the same reason. We are here to HELP and BE HELPED. Please,
let's respect each other. There are those on the OH boards that consider
themselves to be "Experts." Most of these folks do not have any
medical experience. They are patients just like me. It is best to take
any advice you get on the OH boards with a grain of salt (if not the whole
cellar). Some folks have a severe bias towards or against certain
surgeries. There are folks who will TELL you that the surgery you are
considering is WRONG and is BOUND to fail! IGNORE these people. Not every
surgery is right for every person! DO YOUR OWN RESEARCH and and CONSULT
with your PHYSICIAN or your SURGEON! I cannot stress the importance of
doing your own research enough.
There is a revised version of this post at my profile page. I have added
some links to some web sites that have some interviews with some surgeons
that perform weight loss surgeries and have videos that actually SHOW the
surgeries. You can watch the surgeries being performed and get many of
your questions answered by the surgeons as they explain what they are
doing. They explain the positives and negatives of each procedure. My
Profile page can be found HERE:
http://www.obesityhelp.com/member/hubarlow/ . Look for a post called
Surgical Comparisons. If you can't find the post on the profile page, look
for the post in the March Archives.
I hope this helps,
Hugh
— hubarlow
June 6, 2008
I would reccomend going to your local YMCA and join a water aerbics class
and it won't hurt your painful back. AS to the smoking make the kids go far
away from the house to have a cigarette. Far enough that you don't see
them. Thats going to make you want to have one. .I can't even walk 10 feet
but I go in the pool and do my execrise everyday. It makes my fibromyalgia
much better. Good luck, Dawn
— [Deactivated Member]
June 6, 2008
You ARE doing the right thing. Some of us just love food too much and
cannot maintain a healthy weight because of the addiction to food. I LOVE
my lap band!It has changed my life and it will change yours. When you lose
the weight and start moving around more, your self esteem will
skyrocket.You will not let people walk all over you anymore and you will
start taking care of YOURSELF and your needs. Since my lapband, I have gone
from a size 26 to a 12 and still losing.I am training for a 60 mile walk
for breast cancer.I have gone back to colllege to finish my degree, I don't
take crap from my bosses anymore and they seem to like me more now. I don't
put up with crap from my husband or my son and they know it. I am not a
'bitch' now, but I do stand up for myself and do what is right for me. Stay
strong with the no smoking.... make everyone go outside to smoke. I make my
husband go outside and he cannot smoke in my car, even when I am not in it.
I am an EX smoker and plan to stay that way. It could cause a problem with
the anesthesia if you re-start. Good Luck!
— pattyann
June 6, 2008
Have yo ever had a sleep study conducted on you? You may have sleep apnea
and could be a good part of some of your symptoms- depression, memory loss,
etc. Also you should look into water aerobics- that is great for people
who can't do the "regular" routine stuff and it is easy on your
joints. I think you are doing the right thing. You have the laundry list
of issues that go along with obesity and most if not all of those will
either disappear or reduce greatly after surgery. As for your family- you
need to focus on you and your health or you can;t be a good example or any
good to your family if you aren;t right in the head. So I say go for it
and go to all the counselig and support groups around. It will change your
life. Hope this helps Andrea
— millamename
June 6, 2008
Theresa, I want to give you a big hug and tell you it will get better.
First, have you considered water exercise? It would be gentler on your back
and give you the resistance you need to burn calories. Second, find a
support group close to home and be able to really talk about all the issues
that are impacting your life right now. You do have willpower, as you have
not joined in the smoke party in your yard. Third, it may sound selfish but
put you and your needs first. You can not solve everyone else's problems in
you family, only your's. Work on you and set the example for everyone else
to step to the plate. You are young to have this many other diagnosis
related to obesity. I have many of the same diagnosis and I too want to be
a spry 80 yr old running around with my grand children. I want to recommend
a book to you that made a great impact on my life 9 yrs ago. Cheryl
Richardson's "Take Time for Your Life". It helps to focus your
scattered thoughts and set goals. Read it through first then go back and
read it with highlighter and post it notes to digest it. It really helps.
Jackie
— Boggma
June 6, 2008
Try something new and exciting, worry about a very special person in this
world, YOU. You want to be around to enjoy a long life see the great things
weight loss has to offer. You are a strong person to even get this far, go
for it, don't give up. You will be a better and healthier person because of
it.
God Bless and be strong.
— Ira Sansolo
June 7, 2008
Please look carefully at the small print on the TV and in the magazine
adds....They ALL say "RESULTS NOT TYPICAL" ... People dump a lot
of their money into these magical cures and it doesn't work for most of us.
I had most of your medical conditions pre-surgery 3 1/2 years ago...I now
weigh 160 pounds...I'm still overweight, but all my health issues are a
thing of the past...I only take medicine for Hypothyroid now...and the
vitamins to keep me healthy. I would do it all again in a minute...my
outlook is so much better. You cannot take care of everyone else if you
aren't taking care of yourself...Kids, no matter how well you do with them,
are going to be a trial. Spouses too... For me, surgery was the right
thing and it has made all the difference in my view of things. I am on top
of my problems because I have the energy to deal with them. Take care of
you....then you'll be ble to manage the other stuff....Good luck! Allee
— AlleeM
June 7, 2008
i know one thing reading all your letter. Im 67 years old. came from
council bluffs iowa, I had rny in 2005 it saved my life. I highly
recomend you do it as soon as you can my only regret is i did not get it
sooner. God bless yu
— sybiliowa
June 7, 2008
Wow, you certainly have enough to deal with already. Tell your family that
this is time for you!! Not everyone's insurance will cover this surgery so
you are one of the luckier ones. Make sure you mention all this stress to
your psych doctor when you go, there are meds that can help you feel better
and if you're already on them you might need your meds changed. You need
to make sure you are doing this for yourself because obviously your family
is not where you are going to get your support. I think everyone has second
thoughts about a surgery you don't have to have but this is what I think
of...I will need another stress test for my heart and I thought I was dying
with the first, I will need an angiogram that I'm sure I don't want. I
have to take meds every day of my life for my diabetes, high cholesterol
and depression. I'll gladly swap those for some protein and vitamins. Of
all the things I already do that I don't want, if this surgery delays
needing even more done, then I'm all for it. All of my family dies in
their late 50's/early 60's. I want to be older than that and I think this
surgery is going to help me get there. Good luck on your own journey! I
think it will it worth it!! Mary :)
— Mary714
June 8, 2008
Hi Sweetie! You have insurance coverage.... you are in PAIN... Know you
need to do something..... right? OK no need being a basket case dealing
with the thought of surgery, just do it! YOU are worth it and we get one
shot at life. Everything in life is temporary even a little pain... so go
for it! Good Luck and Keep in touch...Hugs, Michele
— Supermom2008
June 9, 2008
Hi sweetie......I see that you've touched a lot of us who had similar
feelings and want to reach out to you ande support you. They are
right....do it for you...it will turn your life around. I also had bad
back, (spinal stenosis) that I couldn't relieve, awful pain in my knees,
hips, ankles, toes......I couldn't walk more than a few feet without
stopping, and water exercise did no good......I could do some of it but was
totally crippled the next day so that I couldn't function. I was on a
variety of meds for pain, heart palpitations, high blood pressure,
etc........the pain meds made me slow and sleepy but didn't do much for the
pain. I was afraid of surgery, too. I went to weight-focused group therapy
and private therapy for years, and lost and regained 100+ pounds over and
over. I had the RNY at Barix Clinic in Langhorne PA on 11/14/06. I have
lost 148 lbs, including the weight I lost pre-op (still have about 40 to
go). It was the best thing I've ever done. I feel strongly that the lap
band is not the best choice for someone with so many other issues, like
you....also like me. The RNY is more forceful in encouraging behavior
modification, and a stronger deterrent to having an 'I don't care' episode.
(my opinion and one of my big issues) It's hard to stay motivated over the
long amount of time it takes to lose the weight, feel better and change
lifelong bad habits.
I had to really ease into exercise, and still am moderate about it. I am
just now able to walk any distance, as well as function around the house
with things like vacuuming, mopping and gardening. DON'T worry about the
exercise until you feel better.
Also, I totally recommend getting into one-on-one therapy for help with the
underlying reasons for eating and turning to food for comfort. These issues
don't go away, and you have to know how to deal with them when food is no
longer an option......sometimes a good cry is the thing that works.
I urge you to take the step, and to TAKE CARE OF YOU......YOU ARE WORTH IT
!!
Please keep us posted on your thoughts and the steps you take. We are all
here to support YOU.
— nwheat
June 9, 2008
Teresa - Put down everyone else's emotional/physical baggage. You are like
me in the fact that you are trying to "fix" everyone's problems
and you can't. It's a hard fact to accept but with work you can do it.
The only problems you can fix are your own. Your going to have to accept
that no matter how much your family is causing themselves problems you
can't fix it. Your husband is aware of what his smoking does. Tell him
that you're NOT going to feel sorry for him if he does this to himself.
Yes, we both know you'll be there for him but I personally think a little
tough love is in order here. I've had the problems with kids and stuff and
now I take care of what I can change. If something comes up that makes me
want to fix it, I go off by myself and come to terms with it. You may need
some antidepressants to help with this. Maybe just good old faith in God.
As far as why you can't stop overeating like you have stopped smoking goes,
that would work if you could stop EATING. If you had a drag off of a
cigarette right now, do you think you would stop there? NOT!
Nobody says that you have to do all your exercises in big groups. I mean
200 crunches a day. Come on girl, give yourself a break. Treat yourself
like you would treat others. Think about what you would say to someone
else if they had your questions. Most of the time we give great advice but
don't allow ourselves the right to take it. Any type of movement is
exercise. Do your crunches where it is comfortable along with your
walking. You might also find that exercising in water is your best bet.
It burns more calories than doing them on dry land and is fun. But most of
all move. Once you loose some weight you'll find that it is extremely
easier to do exercises and also you'll find that you'll want to move.
Most of all - look ahead not behind. You CANNOT change the past. Won't
happen. You CAN change YOUR future. You can find a better place for YOU
mentally and emotionally. Reach for your stars girl.
— VickiJ
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