Hello from the SF Bay Area

[Kassandra]

Currently going through the process of having VSG surgery and am still in the pre-op weight loss requirement phase. Another 27 lbs to go and my surgeon will submit the necessary paperwork and then surgery. Is anyone nearby or has had surgery via Kaiser in the Bay Area?

 

[Larra]

Hi Kassandra!

There are lots of us in the SF Bay area. And some of us are very familiar with Kaiser.
Did you know that you can appeal your way out of the mandatory pre-op weight loss, for which there is NO evidence of any benefit? Kaiser will not like this at all, but the DMHC (dept of managed health care) will back you up.
Did you also know that you are not stuck with just the options that Kaiser tells you about? In other words, that if you want the DS, you can get it? If your bmi is over 50 they won't even fight you on it. If you bmi is under 50 they will fight you, but you can appeal this to the DMHC with a good chance of success. Kaiser does not inform patients about the DS, and even people with high bmi's need to know that they have to request it or no one will mention that it's available. That's a shame.

If you are well informed about ALL your options and the results you can expect, both for weight loss, for maintaining that weight loss, and for resolution of whatever comorbidities you may have, and you still want the VSG, I wish you the best of luck with that. But we are learning more and more about how the long term results are not that great with VSG. Kaiser tries to improve their results by "cherry picking" the patients most likely to succeed, which 1) doesn't work and 2) prevents a lot of people from receiving medically necessary treatment. I think that's a shame.

I hope @DianaCox will see your post and chime in. And, if you look around this site just a little, you can find the article someone posted about results of VSG at 5 years. Short term - pretty good. Long term - not so much.

 

[southernlady]

Welcome, @Kassandra

 

[DuodenalSwitchaRoo]

Welcome! Another Cali girl representin the bay area here I live in England now, but once a Cali girl always a Cali girl

 

[hilary1617]

Welcome, Kassandra! Looking forward to following your journey!

 

[DianaCox]

What Larra said - if your BMI is over 50 and you ask for a referral to a DS surgeon in NorCal, you get Rabkin, one of the best in the world.

 

[newanatomy]

Hello and welcome, best of luck to you!

 

[Kassandra]

Thank you all I did try to maneuver around the weight loss portion since due to some life changes my weight shot back up significantly higher than it was when he suggested the loss. Weight at time of consult 359, Weight increased to 381, Current weight now 357, however even with the loss of the 24 lbs, he is still requiring I get down to 330. I'm confident I can reach the goal, it's just the reasoning he is giving doesn't seem to jive with others that have their procedures at even higher weights than mine so it's frustrating. Anyway, I was opting for the Gastric Sleeve because it seemed to be the least changes to the way the body is already constructed. I am interested in the DS however after looking into it a bit more. In reading it seems however that it hasn't been performed very long as so I am having difficulty finding data on long term effects, ie. complications.

 

[GirlFriday]

Hello and welcome @Kassandra. If you search around this site, you will find lots of information on the DS and the long term results. I, personally, chose the DS because there are some people that are very close to me that had the DS many years ago and they are living complication free and haven't regained the weight eight years out.
I am only four months out so I don't have a lot of the science to back me up, but the veterans here can help you with that. They know their stuff and give good, honest advice.

 

[southernlady]

In reading it seems however that it hasn't been performed very long as so I am having difficulty finding data on long term effects, ie. complications.

It's actually been around since 1988 when Dr. Hess did the first one. When I had my DS in 2011, the vSG was still not covered by Medicare but the DS was.. Medicare didn't begin covering the VSG (which as a stand alone surgery for WL is newer than the DS) until Sept 2012.

 

[DianaCox]

"In reading it seems however that it hasn't been performed very long as so I am having difficulty finding data on long term effects, ie. complications."

I don't know WHERE you could possibly be getting this idea - are you confusing the DS with SIPS/SADI/LoopDS? Because those are NOT the DS, and haven't been around very long - the DS has been around for going on 30 years. I am personally 12 years out.

You need to do a LOT more studying about the various procedures - and to get an OBJECTIVE opinion about the DS from a surgeon who performs it, like Dr. Rabkin. His support group meets the second Wednesday of the month in the cafeteria of St. Mary's Hospital in SF, including a separate infomational pre-op group meeting with Rabkin himself:

San Francisco
Date: 2nd Wednesday of each month
Time: 6 PM - Simultaneous Informational Seminar and post-op meeting.
7 PM - General open meeting for both pre-op and post-op patients.
Place: Cafeteria at St. Mary's Hospital
450 Stanyan Street
San Francisco, CA 94117
Additional details: Parking is available at St. Mary's Hospital parking at the corner of Stanyan and Hayes Street.
For more information please call our office.

 

[Kassandra]

"In reading it seems however that it hasn't been performed very long as so I am having difficulty finding data on long term effects, ie. complications."

I don't know WHERE you could possibly be getting this idea - are you confusing the DS with SIPS/SADI/LoopDS? Because those are NOT the DS, and haven't been around very long - the DS has been around for going on 30 years. I am personally 12 years out.

You need to do a LOT more studying about the various procedures - and to get an OBJECTIVE opinion about the DS from a surgeon who performs it, like Dr. Rabkin. His support group meets the second Wednesday of the month in the cafeteria of St. Mary's Hospital in SF, including a separate infomational pre-op group meeting with Rabkin himself:

San Francisco
Date: 2nd Wednesday of each month
Time: 6 PM - Simultaneous Informational Seminar and post-op meeting.
7 PM - General open meeting for both pre-op and post-op patients.
Place: Cafeteria at St. Mary's Hospital
450 Stanyan Street
San Francisco, CA 94117
Additional details: Parking is available at St. Mary's Hospital parking at the corner of Stanyan and Hayes Street.
For more information please call our office.

Thank you. I've been researching more so since you all have provided further info and will continue to, to make an informed decision. Actually in the interim of this thread I have asked my current surgeon for a possible referral for DS which he said he is willing to do I guess to clarify, what I read was it was not a commonly used procedure prior to the early 2000's although performed- again still researching. It would be nice to see some people that are living with DS that had the procedure in the early 90's I guess is more what I was looking for, to get an idea of 20 yrs out. etc. Could also be because it seems that people have a hard time even getting approved for WLS so maybe the data isn't as readily available as the other procedures...nonetheless that's why these forums exist, so I can confer with the knowledgeable! Thanks for the info on Rabkin as it seems that that's where I will be referred should I choose to go the DS route, wish I would have found this page last week lol

 

[DianaCox]

The good news is, starting around 2000, the DS was "tweaked" to generally be performed with a longer common channel (100 cm on average vs. 50). People have generally had fewer problems since then.

The primary reason that lands DSers in trouble is failing to follow the RULES, which are non-negotiable, no matter what. Protein first, low-ish carbs, annual or more often extensive blood work, and taking every supplement that you need, without fail, no matter what the circumstances - no excuses about how much they cost. It's not that hard, but getting lax i NOT an option - once you start to go downhill, it is MUCH harder to get right again. And the ability to stand up to your treating physicians who don't know their ass from their elbow about the DS, and who will try to give you dangerously bad advice.

The question is, what is your commitment to doing that?

 

[DuodenalSwitchaRoo]

I'm a 2 stage DSer (not recommended but I started at 644 and was 90% belly lol) so I can speak about experience of the sleeve and of the DS.

The sleeve. Easy peasy recovery, sort of lol. Im a wuss! But eating resumed to normalish, but constant dieting, watching cals etc. Weight loss was GREAT.....for 3 months. Then it got really HARD! As someone who was SMO it should have melted off for another year or so. It didn't. I lost 100 in the first 3 months and then hit a brick wall. I contacted my team, who were no help at all. I had my OP on the NHS and in a hospital in London with one of the most popular surgeons in the UK. This meant and I had to figure it all out on my own. The struggle was real. I dieted, exercised (in the pool as after 100lbs off I became cripple) for 2-3 hours a day, 4 days a week.....for TWO YEARS! So for the 4 years I only had a sleeve I ended up losing 200lbs. I was 444lb when I got my DS.

The DS. My SAVIOUR! I must have some seriously jacked up metabolism because I still have to work and fight a lot harder than it seems other do. However, I am also MORE cripple now (hip replacement next month!! yay!) So I made a sedentary lifestyle look super active lol. I'm still losing, slowly, and in stops and starts, but Im also not dieting like I did pre WLS or pre DS, nor am I working out 12 hours a week. So this DS stuff is pretty cool.

There is loads of data out there, the nitty gritty is hidden in medical journals with a limited audience, but you can find nuggets here and there online via google.

Complications. Yup. That shit is REAL! I had several, will spare you the details for now, but I did write about it at the time on here. I have never regretted my DS as after struggling so HARD after my sleeve to be successful and falling on my ass, I knew in my heart this was the ONLY way for me to have a healthy and long future.

I'm now down in the 280's, nearing my surgeons goal (280) and I plan on surpassing that. Might I have been just as successful or even more so if I had the DS in one go? I cannot say, nor can anyone else. I learned a hell of a lot during my struggle with a sleeve. I learned I am strong, I am able, I am super wicked smart and that I am one persistent, stubborn bitch lol. I also had time, A LOT OF TIME between VSG and DS to learn everything that could fit between my ears.

Do your research, listen to your heart, acknowledge fear, but do not let it control you. Fear is the enemy

Good luck!

 

[Larra]

@Kassandra the DS has been a standard of care bariatric surgery for over 25 years - not "new" at all, and not experimental. It has well documented long term statistics that show the highest percentage of excess weight loss, the best maintenance of that weight loss, and the best resolution of almost all comorbidities of any bariatric surgery. Maintenance is crucial - we have seen so very many people with either gastric bypass or sleeve who do well initially but then struggle to prevent weight regain, and often lose that struggle despite truly great efforts. It requires a permanent low fat, low calorie, low carb diet, plus exercise, and even then some people still regain, and/or never get even close to a normal weight.
Given where you are starting (pick any of the weights you listed, doesn't matter which) I believe the DS would be your best hope for a normal or near normal result. I hope, now that you are learning more about it, that you will continue your research. I hope you will check out the support group @DianaCox told you about, as this would be a great opportunity for you to learn more and also to meet some people who live with the DS and who will share their experiences with you. I think that would be very helpful for you. I would also recommend attending a support group with people living with sleeve and gastric bypass, with special attention to the more long term people. What you often find is that fresh post-ops are happy with almost any operation, but it's really the longer term results that tell the tale. I went to such a group several times before I decided I just could not have gastric bypass (sleeve wasn't being done as a stand alone back then) and it was very educational - never met so many unhappy people!
I'm over 9 years post-op, Diana is at 12, and there are other old timers here as well. Check out a sleeve group online - you won't find many old timers there. And on websites like this one, you will find a fair number of people with sleeves wanting revisions to something that works better. And while this should not be the determining factor, I can tell you for sure that if you do have a sleeve and don't get good results, there is no way on earth that you will get Kaiser to cover any sort of revision.