New- too much to think about

[downsize54]

Have posted to another board, was pointed this way. Having trouble deciding on DS vs VSG. Work up progressing with surgeon in Kalamazoo, doesn't do DS. Wt 210, 5'2", diabetic. Am thinking about second opinion re:DS but know this will put everything on hold, and no idea how long that will take. I've already got a year into this counting 6 months of "supervised diet" for insurance. I didn't know of the DS option until recently so didn't ask Really appreciated info given. Just really am confused now about what direction to go.

[smileyjamie]

Welcome!!!!!!

Have you looked at www.dsfacts.com/
That site is loaded with great information!!!!!

[Sandra C.]

I live in Kzoo, started with attending Dr Versemans lecture, turned in all the paperwork, made an apt with him, then found out about the D.S. Attended the closest D.S.surgeons lecture- Dr Kemmeter, Grand Health Partners, Grand Rapids. Find their site on line, ask the desk when he is lecturing for new surgical candidates. they have a meeting you could attend for D.S.support and prospective new patients held on the second Wed. of each month. The next one is Feb. 8th, 6-7:30. Dr Kemmeter is usually attending and Cathy his coordinator will be there too, she has all the answers for beginning the process, and great personality too.

The drive up there is not too long considering the excellent care. I shop in his office store for foods and supplements. The group lectures are so informative. You can attend them before your surgery and after free of charge.

Read all about the duodenal switch at DSFACTS.com, and www.saintmarysweightloss.org/landing/DuodenalSwitch2
www.grandhealthpartners.com/default/our-team/dr-kemmeter

He is the best surgeon for D.S. there, with lots of experience and great surgical support before and after. They fit me into a fast track since I had done so much of the prep work already. About 2 months from my first appointment to my surgery. My date depended on when he had an opening for a D.S. that month.

I would be happy to meet with you for coffee, at Bronson gym to talk over how life is with the D.S. I'm over there exercising most days. Let me know here days and times you are available.

Happy to help,
Sandra

[Sandra C.]

The VSG was the surgery I would have had in Kzoo. Dr. K. said a revision to the D.S. after a first surgery falls short of a first time D.S., with respect to weight loss. My insurance covered the D.S., only one surgery in a lifetime and I only wanted to have one surgery. The risks go up with multiple surgeries, no matter what they are. Limiting how many you have is a good idea. Starting with the VSG, then converting to the D.S. is not advised, but it is possible. Dr. K does revisions all the time.

The D.S. weight loss results compared to the VSG are better because of malabsorbtion, with less likelihood of regain down the line. I wanted to make sure I remained thin in the end once I reached goal weight. I don't feel any different with malabsorbtion, except having a bit more gas than usual if I eat sugar alcohols found in SF candies. My bathroom habits have not changed since surgery.

The D.S. is a tool they say, to help you with your weight loss, its not going to do all the work for you. Making lifestyle changes choosing healthy foods, and exercise is a part of the package to insure life long success. I never thought I would have such success in such a short time. I feel my body is a normal weight now, wearing regular size clothes and I can exercise for hours, enjoying the process!!! I feel healthy. Type 2 diabetes is reversible, with no need for the meds in a short time with the D.S. they say. I didn't have it, but Dr K. or Cathy can fill you in about it.

[Girlrocker]

Hi, and welcome! You've come to the right place, and I have to echo, head over to DSfacts.com and read, it will help you a lot. There are many things you'll also want to consider that are unique to you - your age, your own diet/weight maintenance history, if you can manage the post-op supplement regimen, surgeon, aftercare.

I think most of us can appreciate the sense of urgency, of wanting surgery done yesterday. But don't let that push you into decisions before you have as much information as possible. Take the time, you are WORTH it! It's a small investment for the rest of your life. I think Sandra made you an offer you can't refuse :-) There's nothing like talking to people who have been through the same thing, and talking in person is even better.

I know many people who are doing great with the VSG; for others, the DS makes more sense because it's the most comprehensive, furthest reaching surgery. You want to make the best possible decision for you. Page back and read posts here, too, and ask away!

[downsize54]

Thanks Sandra, PM sent.

[reinventingangela]

I could be wrong but why wouldnt your documented weight loss efforts be applicable to whichever surgery you decide to have? I would think they would meet the requirements of any surgery if they will meet the requirements for one....so I wouldnt stress over that.

As for the DS vs VSG question, I had to ask myself the SAME thing and in being totally honest with myself, while I think the restriction alone surgery has its purpose, for me, I dont trust myself over the long term (meaning 1 yr out from surgery), to not take advantage of the tool that restriction alone provides.

I think for me personally, I will probably need the help from the malabsorption to help me maintain my weight loss longer...not that Im intending or expecting to fail, I just know that I'll do better with a longer window of time for attitude readjustment and behavior modification...not to mention my own particular co-morbidities which probably wont let me live through a yoyo scenario if I fail with just the VSG.

Maybe Im underestimating my potential but in all honesty, Im probably only going to get one shot at this WLS thing and Id rather go balls to the wall to make sure I dont have to head down this road again than to take the chance of having to go through a revision.

I hope you find this helpful

[larra]

There are 2 key questions here:

1. looking at yourself honestly, do you truly believe that restriction alone with give you longterm success, esp given that the restriction lessens greatly with time? While shortterm results of VSG are similar to RNY (with both being inferior to shortterm with DS), longterm results with VSG are unknown. Longterm results with the DS are well documented and best of any wls.

2. You are diabetic. I am assuming type 2 diabetes. Your best chance for a permanent resolution of type 2 diabetes is with the DS, hands down. Results with RNY used to be thought to be pretty good, like 84%, but recent studies have shown that the diabetes often comes back after a few years, and longterm resolution of type 2 diabetes with RNY is more like 44%. Result with VSG are not even close, probably less than 20%, because VSG lacks the metabolic effects of the DS. Worst results for resolution of type 2 diabetes are with lap band.

Something for any diabetic patient to think about! There is more to weight loss surgery than weight loss.

Larra

[downsize54]

Reviewed insurance info tonight, they won't consider DS unless >50BMI, I fall below 40. That may limit choices. Plan to call and see if any changes to their criteria since last June. Also will call another surgeon for consult, hoping they can talk to me before scheduled diet/cardiologist appoinments this month. Wish I had found tese resourses last fall.

[reinventingangela]

You could appeal the BMI over 50 policy....I believe some have on here...especially with co-morbidities...I would ask some of the Vets for their input

[keliblue]

I am 5.3" weight was 225 with co-morbidity. I fought to have the DS and am so glad I did !! ya it took a little longer, no much and changed my life in all the right ways.. I'm 113 now, healthy and NEVER have to diet again.. protien, vitamins and water are my religion now with lots of bacon..lol. Don't settle..

[sherbearmama]

I started looking into the DS primarily because I had type 2 Diabetes. I wanted the surgery that would give me the best chance of reversing the diabetes permanently. I was given the option to go with the sleeve first and then consider the DS at a later date. But I knew that insurance would fight me all the way with a revision to DS. After LOTS and LOTS of research and lots of reading on the boards, I concluded that the DS was right for me. My BMI at my first visit was about 40 and then by surgery day my BMI was around 38--I was considered a light weight. So they do this surgery on lighter weights--especially when we have a co-morbidity like type2 diabetes. I'd definitely look into appealing your insurance if they refuse you the best surgery to solve your health issues (that is, if you decide you want the DS).

Good luck!

[beth28]

I am 5'2", was 229#, and was a type 2 diabetic. I got the DS because I didn't want to be diabetic anymore. I wasn't too unhappy about my weight, but I hated the thought that I might be the next person in my family to die from complications from diabetes.

If the DS is what you truely want, then fight for it. A lot of people on this site have had to fight for their DS. Ask Diana Cox if she has any advice about your insurance. She's great, and has helped many fight their insurance company.

Good luck and keep us posted!

edited for spelling..

[larra]

Your bmi is 38.4. Lots of people have the DS with a bmi between 35-40, which, along with a serious comorbidity like type 2 diabetes, makes you a suitable candidate from a medical point of view for ANY accepted form of wls, including the DS.
And as I said before, there is more to weight loss surgery than weight loss. The fact that you have developed type 2 diabetes already at a relatively low bmi may indicate that weight loss alone won't resolve your diabetes, that the metabolic changes induced by the DS are needed.
We see this insurance limitation by bmi crap all the time. You can fight this, and you can win. The only real question remaining is which operation you want.

Larra

[angelcake]

Note that if you do go the 2 step route many surgeons charge pretty much the full DS cost for just part 2, as they argue that it's because there are adhesions from the sleeve and will take longer.

Also many insurance policies have a single WLS per policy claim clause, so if you're struggling to get it now you'll definitely struggle more later.

Finally if you do want to go the 2 part route find out how much part 2 will cost up front. Plus if you drop to say BMI 34 it may be almost impossible to get the DS even though you're only a whisker away from being morbidly obese.

[downsize54]

Thanks again all for the input. I'm taking advantage of the offer to meet up tomorrow to "talk DS". So appreciate the kind offer to share. Am leaning towards DS if I can get insurance to cover, will be postponing some appointments until I have some this sorted out. Praying insurance will do this, only want one surgery, it's now or never.

[majormom]

Oh, good. You made it over I'm glad you're getting some good info here. Wishing you good luck. Please keep us posted.

--gina

[Deleted]

Welcome and at your BMI, and being diabetic, it should not even be a toss up...go DS...I'm 5'4", weighed 208 (BMI of 35.2) had insulin dependant diabetes and high cholesterol...was approved for a DS without a hitch...MY hitch was finding a surgeon willing to do a DS on a lightweight.

Liz

[jaellie]

Hello, my name is Jill and I am a total food addict! I choose the DS over the VSG because I needed much more then restriction-I need the malabsorbtion. Years of dieting screwed my metabolism. Also, WLS does not fix the head issues with food. For me I can follow the simple rules of the DS-protein first, vitamins based on lab values and lots of water. And who can resist all the meat, cheese and cream to my heavens delight. Please research out all of the WLS options and make an informed decision.

[downsize54]

Just a big thank you to "sscopely20" for meeting up today. A lot of questions answered, decisions made. Very helpful and inspiring.