VSG or DS

[daphne]

I was previously posting on another board and it was very slow and somewhat biased. The information just did not prove to be fully accurate. It was suggested that I post here so I closed the account over there.

Due to my job I do a great deal of research and I have been working on an article outlining the long term aspects of weight loss surgery. My research made me realize this is something I would like to do for myself. My insurance does not cover anything for weight loss. I looked into it a couple of years ago when I found out it was not a covered benefit I dropped it.

My current research has me intrigued. I have plans to pursue this. I have picked a surgeon in Mexico. I live right on the border and I am in that city all the time anyway. I have many contacts there and I have a surgeon but now I am doubting my choice in surgery. The nurse there suggested that I consider DS. She feels I would do well with VSG or DS but felt I should review all my options. Originally I was annoyed with this as I made my decision of VSG but this is an expensive process and I want to pay one time for this.

My BMI is 42, I have no medical conditions, my diet is fairly good now I merely eat far too much food. The idea of eating a few bites of food and feeling full sounds like heaven to me. Is there anyone here that has stats similar to my own that could tell me their deciding factors?

I have been told by one person that he spends about $125 a month in supplements and protein powder. Is that about average for most? What about complications? My insurance carrier does not cover bariatrics and I am concerned that long term should I have a complication, will it be covered regardless of which surgery I choose?

I am on the road and rarely near a bathroom about 75% of my day. Will this be problematic?

If this surgery is done for extremely obese people how will I stop losing if I am not extremely obese?

Thank you for your time.

[west4thavenue]

Hi, Daphne.

I am 6 months out from DS surgery and won't pretend to have all the answers. However, I am happy to share and I know the vets will be more helpful.

If you decide to have the DS, PLEASE choose one of the vetted surgeons listed on this thread:

weightlosssurgery.proboards.com/thread/2084/list-vetted-surgeons-north-america

There are too many accounts of "bait and don't switch", i.e., surgeons who say they do the DS and then try to talk you into something else.  Dr. Ungson in Mexico is experienced and well respected.  There are others in Mexico who advertise the DS but do not perform it.  What you do not want is to wake up after surgery with an unwelcome surprise.

As you can see from my stats, my BMI was 42 also.  I had a number of co-morbities including a history of heart attacks. I live in Texas and did consider Mexico at one time, but chose Dr. Ayoola in Denton instead.  I was, like you, concerned what would happen if there were any complications from surgery or any cardiac events.  As it turned out, I had no complications from the surgery whatsoever, but I did have another heart attack while I was in the hospital that was NOT caused by the surgery.  I was a higher risk and I knew it.  I do not know how your insurance company will handle any complications that can be attributed to surgery.  Please ask them what they would and would not cover. 

I think $125 a month is about what I spend on supplements.  I am able to eat enough protein now, so I don't drink the protein shakes anymore.  They are essential until you can meet your protein intake goals. 

You will not be able to go right back to work right after this surgery.  People with desk jobs need something like 6 weeks to recoup.  The DS is a tough surgery, and that is without complications of any kind.   And yes, you will need to be close to your bathroom for some time following surgery.  For me, it was three months.  For others, maybe not so long. 

I am still learning and expect I always will be, so I will not answer your other questions.  There are people here who have already met their goal weights and have dealt with maintenance.  I'm not there yet, but I'm getting closer! 

Glad you are here!

[daphne]

Thank you for your fast reply!

I am very happy with my surgeon. I do research for a living and I live very near my surgeon, I have many friends in common with him. Dr. Ungson is not on my list of future surgeons. I am sure he is a good surgeon but his staff are unacceptable.

Six weeks off from work is not possible. However, I can do much of my work from home for a short time.

I am still leaning towards VSG but I did agree to consider DS. My BMI is 41, I have no medical issues, I just eat too much food! The idea of eating a few bites of food and feeling full sounds like heaven to me. I would do anything to conquer this hunger.

Congratulations on your remarkable success!

[newyorkbitch]

The problem is with the VSG is that eventually (and for many people it's fairly soon), your stomach stretches and you can eat large quantities again. Also, WHAT you eat matters a great deal too. With the DS, the malabsorption is what keeps the weight off.

You have to wrap your head around the fact that these are major surgeries. You will need significant time off for recovery and you will need to be able to get to a bathroom frequently for quite a while.

Who is the surgeon you are considering?

[daphne]

Six weeks off work is quite literally impossible. My diet is pretty good but quantity is ridiculous! Bathroom issues will be problematic.

I have read the studies, the stats, I have compared surgery types and I still tend to lean towards VSG. I am surprising myself at the stress this is causing for me. I have to make the right decision because this is a one shot deal.

[newyorkbitch]

You are not ready to have surgery - you have to come to terms with how big a deal this is and what recovery is like and what it's like to live with it afterwards.

[newyorkbitch]

If you do the VSG it won't be a one shot deal. You will gain all the weight back and then you will need the DS part.

Many of us have seen this happen many times to many people.

[west4thavenue]

Sept 29, 2014 20:40:18 GMT -5 newyorkbitch said:

You are not ready to have surgery - you have to come to terms with how big a deal this is and what recovery is like and what it's like to live with it afterwards.

I have to agree with nyb, Daphne.  You don't have the recovery time and don't understand the depth of the changes you must make. 

[daphne]

I am going to have one of the surgeries and it will be fairly soon. I will not choose a surgery based on convenience of time off, I will have to cope with it. I am the breadwinner of the family. If I don't work nobody eats. I have put my family ahead of my surgery for financial reasons and I have the opportunity so I am going to do it. I disagree that I am not ready because I don't have 6 weeks to take off work. Apples and oranges.

I have met quite a few people with VSG and 2 with DS. They are not complaining about stomach size and all appear to be doing quite well. I have chatted with many on line but only met a few in person. I will do more research on stomach size a few years down the road.

[newyorkbitch]

So why are you here, Daphne? What do you hope to learn/gain from this board? There are many DSers here.

How many VSGers have you met who are 5+ years out and who have kept all the weight off?

Have you read the board here of people who want to or have revised from VSG to DS ?

Has your research included speaking to people who have not been successful with just VSG?

Do you understand that VSG merely shrinks the stomach, which is a muscle, and expands over time?

Just read all the DSers here who talk about how their capacity to eat has grown over the years (I am such an example).

[bboop]

Listen to NYB she knows what's she talking about. Also westfourthave. I had a major screw up with my first DS stomach...it looked like a large lopsided pancake. I don't know what the heck happened. I had a resleeve and now have a banana shaped stomach. It is now larger, much larger but still smaller than a normal stomach. It does keep the overeating in check, but trust me if I didn't have malabsorption I would be right back at the beginning.

You must take the time away from work to heal. Even a VSG will require that, too. I understand that you have a family and you must provide for them. But at the same time, you must take care of yourself. Currently you have no comorbidities and that's great, but in time, with excess weight I'd say most people acquire some comorbidities.

The $125 figure is about right, plus protein drinks. Sometimes I still drink a protein drink although I get enough protein in via my food.

Don't be offended, by our push to you to make time for yourself and your post operative care. Plus you will need to be near a bathroom for a while. Now with that being said, some people come out of the surgery and go home, R&R for a few weeks and seem to do fine. Some even manage to handle the bathroom portion of the surgery just fine. It's a Your Mileage May Vary kind of thing.

I wish you the best, but I do hope you will think about it long and hard before you get the VSG. I only wish I could have had that and be done with it...but it just doesn't work long term. I had a gastric stapling in the 80s and I lost weight...looked great for 12 years, but then I hit menopause and the weight just seemed to jump back on. The DS basically will give you a long term solution to your problem.

[daphne]

My choices are very simple. I do not have 6 weeks to take off work. I can either have surgery and deal with it or not have surgery at all. It's not a perfect world. I am not offended, I just don't know how to make it more simple. There isn't 6 weeks available unless I want to wait 20 years when I retire. Frankly, I do not even know when I would be able to retire.

Yes, some of the people I met had their VSG over 5 years ago and by the surgeon I am going to. I met two people with DS. One is 3 years post op and 1 is about 18 months. I have met many others but I am referring to those that went to my surgeon.'

I would prefer VSG, it would make life much easier but I want to make the right decision. I do not know what it will be yet. The only given is I will have surgery and soon.

[goodkel]

Hi Daphne and welcome!

My BMI was 41.something when I had my DS with Dr. Ungson 7 years ago. I reached a normal BMI at 2 years and have maintained that loss for five years.

How much time off can you manage?

What type of work do you do? Is it a desk job?

Are you an independent contractor?

Is there any way you can wait awhile longer to save up more money to take more time off?

Most complications will occur shortly after surgery. When you travel for surgery, most surgeons require that you remain in the area for up to a week after you are released so you will be nearby if you have trouble.

You also need to consider what financial safeguards are in place in case there are complications. I required a second surgery and an additional 4 days in the hospital. I was only charged $100/day for the hospital room, just $15 more per day than the hotel charged.

There are only two reputable DS surgeons in Mexico. Dr. Ungson and Dr. Aceves. Whatever you do, do not go to one of those storefront clinics. You require a fully equipped hospital in case there are problems. There have been heartbreaking cases of people who have had severe complications and lost their stomach or died because they went to an inexperienced surgeon just because he was less expensive.

What surgeon were you considering?

The DS is vastly superior to every bariatric surgery in terms of excess weight lost and excess weight loss maintained long term. We have a saying around here,"Think twice, cut once." I was self pay as well and I wanted the best results for my money, the surgery with the best odds of taking off and keeping off my excess weight.

The VSG will help you get the weight off, but you will require portion control and dieting to keep it off in the long run.

[goodkel]

Sept 29, 2014 19:16:35 GMT -5 daphne said:

Thank you for your fast reply!

I am very happy with my surgeon. I do research for a living and I live very near my surgeon, I have many friends in common with him. Dr. Ungson is not on my list of future surgeons. I am sure he is a good surgeon but his staff are unacceptable.

Is this the number you called:

Mexicali Bariatric Center
888-344-3916

Earlier this month, Dr. Ungson was named "surgeon in chief" of the practice where Dr. Aceves works in Mexicali. I do not know if he will still be practicing out of Hermosillo or not. But, I imagine that his staff in Hermosillo is involved with the move and have their hands full at the moment. I would call Mexicali at this time.

weightlosssurgery.proboards.com/thread/9348/dr-ungson-mexicali

[jpcello]

If you are thinking about the VSG vs the DS here are a few thoughts (these are just my thoughts):

Without malabsorption with the VSG you will have to diet once you have reached your goal weight.

The DS requires closer attention to supplements, vitamins, labs, numbers for the rest of your life.

Every surgery can have complications.

You mention that you don't have access to a bathroom for at least 75% of your day. For me personally that would be a major problem.

Recovery time from the DS varies from 4-6 weeks. Some people do it with just two weeks off but I can't imagine doing that. I took 4 weeks off and then back to work P/T for 2 weeks.

You asked how you stop losing weight with the DS - basically what happens is that that farther out you get, the more you eat (and adding more carbs). The more you eat the slower the weight loss. Ultimately the weight loss stops because we adjust how we eat.

I can't answer your question about insurance. My DS was covered by insurance but I have since changed jobs. My other jobs have always paid for labs, iron infusions, bone density, etc. I have not had any major complications (additional surgeries). I suggest you ask your insurance company these questions.

I spend at least $100 per month on vitamins, supplements, etc. Plus any co-pays etc, for anything medical related to my DS.

I have known several people who have been successful with the VSG. I've also know people who were not successful with the DS. It's all about you. No matter what surgery you choose, you will still have to work at it. With the DS it can be a little more work because you really have to re-learn how to eat. Things you liked before surgery may not work after, and vis-a-versa.

No one can choose the surgery type for you.

[newyorkbitch]

Daphne, if you can't control what you eat now (quantities), then what makes you think you will be able to do so in the future? With the VSG, if you eat in quantity, slowly but surely your stomach will stretch. With the DS, the stomach will stretch too, but you have the malabsorption to keep the weight off. That's the beauty of the DS and why it works long term.

Yes it's a big deal surgery, but hopefully you do it once and you're done.

Why won't you tell us the name of the surgeon you are considering? There is a lot of collective experience here on this board.

[newyorkbitch]

It's not about having surgery - it's about the entire rest of your life. That's how you have to make your decision.

[bboop]

Well said NYCB.

[fullhousemom]

I think one of the most important factors in deciding whether you choose the sleeve or the DS, is the volume of the food one consumes. If you consume a lot now, you will consume a lot later. The stomach will stretch, you lose the restriction, and the weight comes back on. The same psychological reasons you consume a lot of food now, will not go away after surgery. You will definitely have some restriction initially, but it just won't work out long term.

For those you know who have been successful with the sleeve, ask them if they were volume eaters to begin with. Ask how long they have kept the weight off. If it's only been a couple of years, keep in mind they are still in the honeymoon phase of their surgery.

I was a lightweight, with a bmi close to 40. I frequently wish I would have had only the sleeve, as I, too, had no health issues. But I was never a volume eater, unless it was a family gathering or restaurant. I will never know if the sleeve would have been enough for me long term. And that's ok, because I do know that I have the tools in place to keep it off long term, with the biggest tool being the malabsorption.

Another thing to consider is what your long term goal is. If you want to be sleek and thin, or are considering plastics, then DS is the only way to go. If you just want to lose some weight, and don't care if you are a little "plump," then go with the sleeve. The outcomes of the two surgeries will be different. Only you know what you're really willing to be happy with.

[fullhousemom]

Rereading your post, it says you are working on an article about the long term aspects of weight loss surgery. Look at the long term stats on how many keep the weight off among the various surgery types. See if you are willing to take the risk of being on the side that DOESN'T keep it off. Unarguably, the DS has the best long term statistics. That was an easy sell for me. Maybe someone else has a link with the stats. I am not well versed in obtaining that kind of information.

[daphne]

I disagree that the only good surgeons for DS in Mexico are Dr. Ungson and Dr. Aceves. Dr. Aceves died about 3 months ago from what I understand. I am very sure Dr. Ungson is a good surgeon but he is not the right surgeon for me, I will not go to him. In all my research Dr. Aceves was not experienced enough for me to go to him if I could. I did choose a surgeon after a great deal of research and he is who I will go to.

My job is part desk/part field. I can make it desk job for a couple of weeks with no problem.

I am not really traveling for surgery, I live in California on the border and I am about 10 miles from my surgeon. He is in Mexicali. He works out of the same hospital as Dr. Aceves did, he was partners with Dr. Aceves for many years. He is one of 2 surgeons that proctored Dr. Aceves in DS. Dr. Ungson is the other. The surgeon I am going to has far more DS experience than Dr. Aceves did. I am very comfortable with my choice of doctors.

Yes, the phone number you list is where I called. Nina is the person I spoke with. He is simply not the surgeon for me. He would fly to Mexicali the day of surgery, do surgery, and fly home that evening. A band doctor would do my aftercare. I am not comfortable with that and I do not believe you would be comfortable with that either. Dr. Ungson is still practicing out of Hermisillo but Nina is coordinating for him now that Dr. Aceves passed away. She is basically a medical tourism coordinator now instead of working as an employee for Dr. Aceves. I have had very negative experiences with Nina. She has been dishonest from the beginning. For example, she told me Dr. Ungson is FACS. He is not. I do not care that he is not FACS, I care that she lied to me. That is one example of many. She required a $500 non refundable deposit to even speak to Dr. Ungson on the phone to discuss options. Then another $3,000 non refundable deposit to schedule surgery. That is not standard in Mexico.

Bathroom issues seem to be the biggest obstacle for me at the moment in trying to determine the logistics of this.

I very much appreciate the time everyone has devoted to answering my questions. This board is a wealth of information!

[bboop]

Hey Daphne, go over and read the post from Taleii..she had a band and is seeking a revision to the DS. Look at what she has to say.

[daphne]

Bboop,

I guess it is lucky for me I am one smart cookie that knows how to research and I will not be going to such a surgeon. My choice of surgeons was limited. The doctor I am seeing is the only surgeon I would see other than Dr. Ungson and as I explained, Dr. Ungson will not be doing my surgery.

People here are suggesting an inexperienced dead surgeon to do my surgery and you suggest I do not know what I am doing? Dr. Aceves died in a plane crash some time ago yet Nina is merely claiming he isn't doing surgery anymore.

I would think he isn't doing surgery considering the circumstances.

[newyorkbitch]

I cannot imagine why you won't share the name of this surgeon. Perhaps there are people here with experience with him.

[west4thavenue]

Here's the thing, Daphne. You came here requesting information and you also went to another board for that information. Just as you did on the other board, you have done nothing but argue with everything that people have taken the time to offer you.

I don't engage in arguments as a rule, and I REALLY don't like to feel that my time is being wasted. I am very concerned about you, however, as it appears you are going to be making a quick decision that will definitely have a tremendous impact on your life and the lives of those who love you. For this reason, I will leave you with just one last thought before I stop reading or posting on this thread:

DO NOT HAVE THE DS. It is NOT a match for you. You do not have the time to recover before returning to work and you will not be able to deal with the bathroom issues when you do return to work after only two weeks. That is an inarguable fact, Daphne. Thorough research will support my position on this. There is one more reason why this surgery is not for you, or at least, not for you at this time in your life. Everyone who has this surgery must be able to RECEIVE, ACCEPT and IMPLEMENT information about diet, supplements, blood work, complications and many other issues that will affect the DS patient for the remainder of his or her life. This does not describe you, Daphne. And I don't need to do any research further than I already have about you to be able to tell you that.

I wish you well.

[daphne]

I can appreciate where you are coming from. But please remember, I did not ask about surgeon advice. I know what I am doing. Just because I disagree with you does not mean I am dead wrong. I have lived on the border all my life except for my college years. I know people in Mexicali in every field of work. I did do my research, I did not make this decision quickly, the only decision left is which surgery to have.

A couple of the people I have encountered on this board and another have issues of some sort. I do not understand the mentality but it really doesn't get them very far in my case. I know Mexicali like the back of my hand. Do you? Do you know all the surgeons there? Do you know the hospitals well? The owner of the hospital that Dr. Aceves used is one that advised me. Dr. Ungson and my surgeon work out of that hospital, the owner of the hospital (a surgeon) told me either doctor is highly skilled and experienced. Either one would be fine for a VSG or DS.

Everyone locally is wrong, the people that know these surgeons personally and work with them are all wrong and people on the internet are the only people that are correct. Is this accurate?

I wonder if more people would be honest with you about their surgeons if they could be honest without a beating. I see another person posting on this page (perhaps it was the other) that had surgery by my surgeon and I looked at her posts. Nowhere does she tell the truth of who did her surgery.

Maybe it is because she can't.

I haven't argued about anything. Surgeon choice is not up for debate. I have to live with the good and the bad of the surgeon so I have to make the decision that is right for me. Having a Lap Band surgeon do all my aftercare and resolving potential complications is not responsible medical practice and you are going to have a tough time showing me how that is superior to my decision. Going back to work earlier than what is ideal is not a debate, it is a reality. It is that or not have surgery. I agree with the bathroom issues, that is something I do not know how to overcome right now. So what have I argued about?

I have not asked anyone to agree with me but please stop insulting me. This is not the way to educate people. I might just know more about this hospital and surgeon than you.

[newyorkbitch]

Who is the surgeon?

[goodkel]

Sept 30, 2014 16:18:17 GMT -5 daphne said:

I disagree that the only good surgeons for DS in Mexico are Dr. Ungson and Dr. Aceves. Dr. Aceves died about 3 months ago from what I understand. I am very sure Dr. Ungson is a good surgeon but he is not the right surgeon for me, I will not go to him. In all my research Dr. Aceves was not experienced enough for me to go to him if I could. I did choose a surgeon after a great deal of research and he is who I will go to.

My job is part desk/part field. I can make it desk job for a couple of weeks with no problem.

I am not really traveling for surgery, I live in California on the border and I am about 10 miles from my surgeon. He is in Mexicali. He works out of the same hospital as Dr. Aceves did, he was partners with Dr. Aceves for many years. He is one of 2 surgeons that proctored Dr. Aceves in DS. Dr. Ungson is the other. The surgeon I am going to has far more DS experience than Dr. Aceves did. I am very comfortable with my choice of doctors.

Yes, the phone number you list is where I called. Nina is the person I spoke with. He is simply not the surgeon for me. He would fly to Mexicali the day of surgery, do surgery, and fly home that evening. A band doctor would do my aftercare. I am not comfortable with that and I do not believe you would be comfortable with that either. Dr. Ungson is still practicing out of Hermisillo but Nina is coordinating for him now that Dr. Aceves passed away. She is basically a medical tourism coordinator now instead of working as an employee for Dr. Aceves. I have had very negative experiences with Nina. She has been dishonest from the beginning. For example, she told me Dr. Ungson is FACS. He is not. I do not care that he is not FACS, I care that she lied to me. That is one example of many. She required a $500 non refundable deposit to even speak to Dr. Ungson on the phone to discuss options. Then another $3,000 non refundable deposit to schedule surgery. That is not standard in Mexico.

Bathroom issues seem to be the biggest obstacle for me at the moment in trying to determine the logistics of this.

I very much appreciate the time everyone has devoted to answering my questions. This board is a wealth of information!

Then perhaps you should have called Hermosillo.

I recommend avoiding "medical tourism coordinators", too. They are unnecessary and only increase the cost of surgery.

So who HAVE you chosen? You have yet to give us a name.

How many weeks can you take off from work? Did they give you any idea how many days you would be hospitalized barring complications?

Yes, early out bathroom urgency is a reality. The minute that you feel you have to go, you'd better start heading in that direction.

[daphne]

It makes far more sense to have a local surgeon and my surgeon is about 10 miles from my home. He is a mile from the border, I am about 9 miles from the border. I disagree with Dr. Ungson if he feels a band surgeon can handle a DS complication. He is still not a surgeon for me regardless of state. If you want to go to him for surgery I am happy to provide a couple of phone numbers and an email address. I am not going to him. I have made the decision that is right for me.

By the way, the band surgeon would only follow me for 24 to 48 hours. Then a non surgeon who specializes in nutrition will complete my post op hospitalization. Do you realize that if I had a major complication the surgeon I would have to call is the one I am already going to anyway?

Hospital will be a full week and my surgeon will be following me the entire week.

A bathroom is still a big issue for me. If I decide on DS I will have to figure out how to deal with it.

[newyorkbitch]

Why are you here Daphne ?


How much time do you think you're going to take off from work?

Why is the name of your surgeon a secret?