hello from the newbie!

[LuvNme]

Hello all! I'm new here. Never even heard of this site til a few days ago when someone on a another website told me about it. A little about myself: I had the band in 2005. While it wasn't always a pleasant experience, I did manage to lose approximately 70 pounds. Unfortunately, a few years in, my fills just stopped working; each one would last less and less as time went by, to the point where I would have a fill and be starving and able to eat a few hours later. I won't get into the emotional stress and toll this all took on me, especially when I was accused of eating unacceptable foods, which was not the case! Fastforward to today, and here I am almost at my starting weight and preparing to see my OH surgeon after not seeing him since 2009. I will be having my band removed since it is broken in 3 different places and hasn't served me in anyway since 2009, which is the last time I had a fill. Although I have major anxiety about even thinking about having another form of bariatric surgery, I know it is needed. I will be speaking to my surgeon about my options when I see him this Thursday. Hoping to learn all I can here as well as share my journey and experiences with you all and hopefully offer support and encouragement to members.

 

[DSRIGGS]

Hello and welcome luvnme

I am glad you found this place as there is a wealth of information and numerous people who had their band removed and were revised to a DS. The DS provides the best long term weight loss of any bariatric surgery and resolves comorbidities for most people.

Do you have any comorbidities? Type 2 diabetes, hypertension, high cholesterol or sleep apnea? If so you need to consider the DS. How much do need to lose? These factors all influence your choice if surgery and it is YOUR CHOICE not the surgeon's decision. As we like to say here, pick the surgery that is right for you and then pick the surgeon. If a surgeon doesnt do a specific surgery they are not going to recommend that surgery to you.

Can you share information as to any comorbidities you might have, your height and BMI/weight, and the surgeon you're planning to see?

Again, welcome

 

[southernlady]

Welcome @LuvNme
Sorry the band failed you...but it is, unfortunately, an all too common story.

 

[JuliaDS]

Hello and welcome!

 

[Clematis]

Welcome!

Please keep in mind that no surgeon will recommend a surgery s/he doesn't perform. A Chevy dealer doesn't recommend a Mercedes. If you are interested in the DS -- and we on this site lean heavily towards both the restrictive and malabsorption of the proper DS with two anastomoses to resolve excess weight and comorbidities -- and your surgeon does not perform this, it will not be mentioned or you may be told it is not a safe surgery. Be prepared to get another opinion.

 

[LuvNme]

Thanks so much for the information everyone as well as the warm welcome! @DSRIGGS , as far as comorbidities, I had more until about a year ago. When my labs came back showing my sugar levels were high and i was pre-diabetic, I immedoately made some changes in my diet, and my levels are now perfect. Also, I developed a thyroid disorder in 2009, but it has been stable for a little over a year so far. I had an overactive thyroid but managed to gain weight rather than lose. Go figure! Prior to band surgery in 2005, I was diagnosed with PCOS and metabolic syndrome, so although I try to eat right and exercise, the weight barely budges, unless I do an extreme, clean paleo diet. It's been crazy! My height is 5'4.5 and my weight is 225 lbs. (My higest weight prior to the band was 260 and i lost 25 lbs right before my surgery. I got down to 160 with the band before it started malfunctioning on me). My question for you (and everyone else) is: is my weight considered too "low" for the DS?? I've already encountered 2 surgeons who have told me there's no way they'd even consider recommending or doing a DS on me, despite my metabolic issues. As far as I know, I don't think anyone here in San Diego performs the DS. However, I have heard THE BEST is near me up in LA, I believe?? Dr. Kadasian (sp)??? I will be asking my surgeon about this Thursday, and my gut tells me he will agree with the belief that the DS is "too extreme" for me. And I'm not so sure how I will feel about it if he does. I trust him and feel he is a great surgeon. However, he IS the one who refused to do an RnY and insisted the band was the way to go, and look at me now!! At that time I wouldn't have gotten an RnY anyway due to fear, but it wasn't even considered or offered as an option (the sleeve was not offered here at that time). I will definitely be posting here and sharing the outcome of Thursday's appt. Hope everyone is enjoying their weekend

 

[Clematis]

The switch part of the DS may cure PCOS. Do a search on this forum for more info on that. This and a BMI >35 qualifies you for a DS if you dig your heels in with more stubborn surgeons. (Many if not most docs do not count the half inch and will figure your BMI at 5'4".)

Are you insurance or self-pay? If self-pay, consider Esquerra at Mexicali Bariatric Center. Excellent surgeon and facilities. And he follows the >40 BMI or >35 with comorbidities like the NIH and Medicare.

 

[DSRIGGS]

Thanks so much for the information everyone as well as the warm welcome! @DSRIGGS , as far as comorbidities, I had more until about a year ago. When my labs came back showing my sugar levels were high and i was pre-diabetic, I immedoately made some changes in my diet, and my levels are now perfect. Also, I developed a thyroid disorder in 2009, but it has been stable for a little over a year so far. I had an overactive thyroid but managed to gain weight rather than lose. Go figure! Prior to band surgery in 2005, I was diagnosed with PCOS and metabolic syndrome, so although I try to eat right and exercise, the weight barely budges, unless I do an extreme, clean paleo diet. It's been crazy! My height is 5'4.5 and my weight is 225 lbs. (My higest weight prior to the band was 260 and i lost 25 lbs right before my surgery. I got down to 160 with the band before it started malfunctioning on me). My question for you (and everyone else) is: is my weight considered too "low" for the DS?? I've already encountered 2 surgeons who have told me there's no way they'd even consider recommending or doing a DS on me, despite my metabolic issues. As far as I know, I don't think anyone here in San Diego performs the DS. However, I have heard THE BEST is near me up in LA, I believe?? Dr. Kadasian (sp)??? I will be asking my surgeon about this Thursday, and my gut tells me he will agree with the belief that the DS is "too extreme" for me. And I'm not so sure how I will feel about it if he does. I trust him and feel he is a great surgeon. However, he IS the one who refused to do an RnY and insisted the band was the way to go, and look at me now!! At that time I wouldn't have gotten an RnY anyway due to fear, but it wasn't even considered or offered as an option (the sleeve was not offered here at that time). I will definitely be posting here and sharing the outcome of Thursday's appt. Hope everyone is enjoying their weekend

Yes, Dr Keshishian in Glendale is the best in the world. I am biased as he did a revision on me due to malnutrition from the guy here in Peoria, IL where I live, making my Alimentary Limb too short (made it 150 cm when it should have been 300). dssurgery.com is his website and there is tons of great information there. Diagrams of all the procedures, research, his personal blogs, his personal contact information....and let me tell you he is like no Dr you have ever met as he will respond to your emails directly and very quickly, and he is one of the nicest and most humble human beings you will ever meet....AND....he is incredibly talented, especially at revisions. You can email or call their office and they will answer questions for you.

The myth that the DS is too extreme for those who aren't SMO, is just that, a myth. The switch component is what keeps the weight off and allows you to eat to your heart's content the rest of your life (of course you have to focus on protein first but you can eat whatever you want). With the RnY GBP you have the potential for dumping (don't ever let anyone tell you dumping is a good thing...it isn't, it is horrible) because you won't have a pyloric valve. The VSG and DS both retain your pyloric valve and eliminate the possibility of dumping Additionally with an RnY the weight comes off for a year or two and then most baloon right back up to where they were at because the stomach stretches so you can eat a lot and you have no malabsorption. I am very biased but the only WLS I even considered was the DS. The RnY simply doesn't work and the VSG for those with a metabolic disorder doesn't provide satisfactory weight loss. If you don't have a metabolic disorder the VSG can be successful. We have a few here who are doing well with their VSG.

Best of luck to you. There is a ton of information on this site, so read through old posts. Additionally as I mentioned Dr K's site is also a wealth of knowledge. I love his diagrams of the different procedures....oh btw, he will not do an RnY GBP or Band as he told me in his training in Detroit all they did was fix broken RnY GBP's.

 

[BebeZed]

Welcome @LuvNme! I had lap band surgery in 2008 and it never did work for me... I only lost about 40 pounds despite all my best efforts and I lost the ability to eat dense protein without throwing up. I was revised to DS last October and I couldn't be happier! I'm glad you've decided to get rid of that doggone band. As Clematis said, your surgeon will not recommend a surgery that he doesn't not perform so please keep your options open. Dr. K would be an excellent choice (if I'd had insurance to cover him he would have been my first choice!) or if you're self-pay, Dr Esquerra in Mexicali (as Clematis mentioned) is an excellent choice too and his office would provide transportation between SD and Mexicali.

The best of luck to you!

 

[southernlady]

Thanks so much for the information everyone as well as the warm welcome! @DSRIGGS , as far as comorbidities, I had more until about a year ago. When my labs came back showing my sugar levels were high and i was pre-diabetic, I immedoately made some changes in my diet, and my levels are now perfect. Also, I developed a thyroid disorder in 2009, but it has been stable for a little over a year so far. I had an overactive thyroid but managed to gain weight rather than lose. Go figure! Prior to band surgery in 2005, I was diagnosed with PCOS and metabolic syndrome, so although I try to eat right and exercise, the weight barely budges, unless I do an extreme, clean paleo diet. It's been crazy! My height is 5'4.5 and my weight is 225 lbs. (My higest weight prior to the band was 260 and i lost 25 lbs right before my surgery. I got down to 160 with the band before it started malfunctioning on me). My question for you (and everyone else) is: is my weight considered too "low" for the DS?? I've already encountered 2 surgeons who have told me there's no way they'd even consider recommending or doing a DS on me, despite my metabolic issues. As far as I know, I don't think anyone here in San Diego performs the DS. However, I have heard THE BEST is near me up in LA, I believe?? Dr. Kadasian (sp)??? I will be asking my surgeon about this Thursday, and my gut tells me he will agree with the belief that the DS is "too extreme" for me. And I'm not so sure how I will feel about it if he does. I trust him and feel he is a great surgeon. However, he IS the one who refused to do an RnY and insisted the band was the way to go, and look at me now!! At that time I wouldn't have gotten an RnY anyway due to fear, but it wasn't even considered or offered as an option (the sleeve was not offered here at that time). I will definitely be posting here and sharing the outcome of Thursday's appt. Hope everyone is enjoying their weekend

Pre-diabetic is still on your chart even with lifestyle changes. Even staying with those changes, diabetes can still progress and that would give you full blown diabetes. Also, while bariatric surgery helps PCOS, it may not CURE it.

My pre-op weight was 208 which at 5'4" gave me a BMI of 35.2. MOST surgeons also considered me too lightweight but in MY favor was my full blown diabetes...I am a type 2 and was insulin pump dependent. I still had to shop around. Cause even tho Medicare had NO issue approving me for the DS, most wanted me to have the RNY cause the DS was "too extreme". I dug in MY heels and convinced a surgeon I knew what I was asking cause of the chance of RH after the RNY and my absolute requirement for NSAIDS. And back in Jan 2011, Medicare did not cover the VSG...that was not an approved Medicare option until July 2012.

Some doctors are more amiable to lightweights (esp diabetics and that includes pre-diabetes) getting the DS. Others are buried in the dark ages thinking the DS is only for those above a 50 or 60 BMI.

 

[sue222]

Hello and welcome -I'm a newbe too and seeing a uk surgeon 22/2 I too wondered if there was a lower weight range for a DS (i'm an RNY fail) currently 39/40 bmi -So good luck on your journey.

 

[hilary1617]

Hi and welcome @LuvNme and @sue222 !!! DS was one of he best decisions I ever made and it resolved my PCOS symptoms. That said, *TMI alert* not sure I am thrilled about having a period every month now. Anyway, glad you're hear and look forward to learning about your journey!

 

[DSRIGGS]

Pre-diabetic is still on your chart even with lifestyle changes. Even staying with those changes, diabetes can still progress and that would give you full blown diabetes. Also, while bariatric surgery helps PCOS, it may not CURE it.

My pre-op weight was 208 which at 5'4" gave me a BMI of 35.2. MOST surgeons also considered me too lightweight but in MY favor was my full blown diabetes...I am a type 2 and was insulin pump dependent. I still had to shop around. Cause even tho Medicare had NO issue approving me for the DS, most wanted me to have the RNY cause the DS was "too extreme". I dug in MY heels and convinced a surgeon I knew what I was asking cause of the chance of RH after the RNY and my absolute requirement for NSAIDS. And back in Jan 2011, Medicare did not cover the VSG...that was not an approved Medicare option until July 2012.

Some doctors are more amiable to lightweights (esp diabetics and that includes pre-diabetes) getting the DS. Others are buried in the dark ages thinking the DS is only for those above a 50 or 60 BMI.

Yep. It still amazes me how so many of these surgeons just don't use science. The science if data is tracked and studied shows that the switch with proper limb lengths gets an individual into a healthy equilibrium whether they were a huge fatass, in between fatass like me or a smaller fatass.

That has been my biggest shock with this whole endeavor, just how intellectually lazy some of these great cutters are. How can you not give a shit about your patients and be curious how your patients are doing and then adjust your techniques accordingly. Thank goodness for Dr K and a handful of others who do care and push the envelope by using science.

 

[hilary1617]

@DSRIGGS , just to play devil's advocate, surgeons like mine may stick with a single cc length for a number of vreasons e.g. repeatability/consistency of procedure; OR time; successful history of doing so in their practice as measured in terms of low complication rate over time; etc. I'm not sure I would diagnose all surgeons who don't use Hess with a case of laziness.

 

[DSRIGGS]

@DSRIGGS , just to play devil's advocate, surgeon's like mine may stick with a single cc length for a number of vreasons e.g. repeatability/consistency of procedure; OR time; successful history of doing so in their practice as measured in terms of low complication rate over time; etc. I'm not sure I would diagnose all surgeons who don't use Hess with a case of laziness.

I would venture to say that most bariatric surgeons have very little data on long term outcomes of their patients because in general DS surgery after care is poor so many patients don't see their DS surgeon for aftercare. As we knew from here, most DS patients don't follow with their surgeon but with their PCP.

I no longer see Dr Marshall who trained for the DS under Prachand who I believe is a partner of your Surgeon's. When I went to him because my numbers and weight were tanking the fool told me that I was the "poster boy for DS health as my labs were great"....as I told him I was on 400,000 IU of creon daily because of his negligence and my lab values were out of range in many cases. He said come back and see me in 30 days, even though I had dropped almost 20 pounds in two weeks at the 18 month mark. He said he would maybe extend the common channel then but "there was really on science bhnind how much we add". That was intellectual laziness because their is science telling us exactly what to do. Furthermore he looked at me like I was crazy when i told him that Dr Keshishian and I had discussed lengthening the Alimentary Limb. It amazes me how ignorant even some surgeons are to to the role the AL plays in the DS. Dr Marshal is an excellent trauma surgeon but frankly has no business doing the DS if he doesn't take the time to to do the research and fully understand the role of the AL. He was intellectually lazy in this case.

The cookie cutter DS works for some who happen to have a small bowel length that matches up with 100cm CC and 150cm AL (can't be a huge number because that would mean a 500cm sbl), but it leaves too many people at risk of malabsorption or inadequate weight loss for NO SCIENTIFICALLY BASED REASON. We have scientific studies showing the Hess method works. It takes 15 minutes more to measure the small bowel and optimize the procedure to the patient. That is why I use the term intellectually lazy because in my opinion these surgeons aren't searching out the best science.


This is just my opinion and I respect your right to disagree. This just happens to be very personal for me because I feel Marshal is guilty of malpractice for what he did to me, but because the ASMBS considers the Cookie Cutter DS a standard of care I am stuck dealing with the outcome, when it was so easily avoidable had Marshal done a little research. I have spent 2 years suffering from this man's negligence but I can't do anything about it.