Hello

DonRobbie

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Jan 31, 2018
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Hello! *cautiously waves*

I'm 46, married 25 years, father of four grown kids, and have worked as a truck driver for about 14 years. I've been overweight since I was a teenager and now have a BMI of 53 (368#, 5'9"), along with Sleep Apnea, prediabetes, and arthritis in my knees and hips. My company's health insurance does not cover Weight Loss Surgery so I am going to have to self pay, which probably means Mexico.

Have been trying to decide what procedure to have. My primary care physician recommended a Sleeve over a bypass because of less complications. Given my high BMI I think I'm going to have to have a malabsorbtion element in addition to restriction to get down to a good weight. The DS has good long term results I'm nervous about the adaptation period. Missing work for 6 weeks (fair bit of heavy lifting at work) or so is already going to be a hard sell. Needing to do lots of potty breaks for a few months afterwards isn't going to help me win friends and influence people. Also considering a mini-gastric bypass or a SIPS/SADI, but both have are a bit lacking on good long term data (plus I really don't want to deal with the blood sugar rollercoaster of a bypass).
 
Welcome! It sounds like you're off to a good start on getting your facts in hand. DS sounds like a good fit for you. The thinking you'd need overly frequent potty breaks isn't necessarily accurate, depends on individual and on food choices among other things.

I had my DS done in Mexico for same reason, insurance excluded any WLS. Dr. Esquerra is highly recommended here and is who I chose after much research. My bmi was 43-45 during time when I contacted his office and got the surgery. I'm 5'1", female and was 58 years old at time of surgery in 2016.

I'm not sure, but he might have a limit on BMI for the DS. You'd have to ask. He might want to do sleeve first then do second stage of DS after you lost some weight. From research and talking to people it seems doing in one surgery yields most efficient results. There are self pay possibilities for here in the states as well which I'm sure others will tell you about. Ask anything you want.

Susan
 
We have other people here who drive for a living. And don't settle for that 2 stage thing unless you have SERIOUS health issues...but it doesn't sound like you do if you can do the job you do! But the recovery time and the no lifting restrictions are real and not negotiable. You have to take the time off to heal and learn to manage your new body. If you have diarrhea in the beginning, you treat it. Imodium is your friend. Once you get the hang of things you will probably poop a couple times in the early morning and maybe again at night and that's it.

People expect great things from the sleeve but here is the truth. It is just another diet with a smaller stomach. Sorry! We all want it to be more/better than it actually is. You would have great results in the beginning but then the regain begins. How have diets worked for you in the past? The DS is your best option to lose the weight and keep it off. And Esquerra is your best option to get it done!

Best of luck!!!
 
Hi and welcome!
You have the right instincts - having a malabsorptive (and metabolic) component makes a huge difference for long term results, and the DS has the best long term results of any bariatric surgery not just for loss of excess weight, but also for maintenance of that weight loss AND for permanent resolution of almost all comorbidities, including sleep apnea and type 2 diabetes. Also, with gastric bypass, NSAIDs are contraindicated for the rest of your life, while you can take them safely (in appropriate doses) with the DS. You already have arthritis, the weight loss will help with that but not reverse it (and all of us tend to get more joint issues as we age). And dumping is rare with the DS as well.
With Mexico, well really anywhere, it's very important to have a surgeon with lots of experience, and Dr. Esquerra is the only one in Mexico that most of us here would recommend. If he does have a bmi limit or 50, you aren't that far off from that, and it would be well worth the effort to lose 3 bmi points worth of weight to have the best surgeon you can get.
 
How have diets worked for you in the past?

I've lost 30-40 pounds more than half a dozen times. It's always ended badly. Most recent was about 3 years ago. I started at 330, got down to about 295 and was hitting the gym 3-4 times a week, then the wheels came off. Went on Metformin a year ago at 345. 368 at my last visit. My bathroom scale only goes to 300 so I can't monitor accurately between doctor visits. I've been dieting since I want to my family doctor about 2 weeks ago and she a) freaked about my decline in health in the last year and b) recommended weight loss surgery.
 
Can't post links, but saw this paper:
"Long-term (>10 Yrs) Outcome of the Laparoscopic Biliopancreatic Diversion With Duodenal Switch." Bolckmans R, Himpens J.

This is concerning but that doesn't seem to mesh with what I've seen of DS survivors. There are complications but it doesn't seem like almost half are going back under the knife.

Don't want to freak folks. Here's a counterpoint
"Current Outcomes of Laparoscopic Duodenal Switch" Laurent Biertho,corresponding author Frédéric Simon-Hould, Simon Marceau, Stéfane Lebel, Odette Lescelleur, and Simon Biron
 
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I've lost 30-40 pounds more than half a dozen times. It's always ended badly. Most recent was about 3 years ago. I started at 330, got down to about 295 and was hitting the gym 3-4 times a week, then the wheels came off. Went on Metformin a year ago at 345. 368 at my last visit. My bathroom scale only goes to 300 so I can't monitor accurately between doctor visits. I've been dieting since I want to my family doctor about 2 weeks ago and she a) freaked about my decline in health in the last year and b) recommended weight loss surgery.
OK, you get my point! I would bet most of us lost and gained hundreds of pounds!
 
I'm in Terre Haute, IN. I drive to Rock Island, IL and back 4 days a week at my job. I work for a company that sells food to restaurants and institutions. Because of some corporate shenanigans I'll be moving to a different operating company in a few months and be shuttling freight from Cincinnati, OH instead of Rock Island, IL. I'll keep my Seniority and accumulated sick time, but I'm not sure how FMLA works (ie will I have to wait a year after I'm "hired" by the new place) and also will need to take the temperature of management at the new outfit.

If the new place is a cluster or I can't survive on what they're paying (new place is non-union and all we've been told is it has a different pay structure than we have now) that 'simplifies' things a little bit. If I leave I can cash out my 401k and that would cover the cost of a DS (though not much more). Otherwise my best guess at a plan is to take a loan in a year or so along with some leave. In the mean time I'm trying to lose a little weight and get more active.
 
My hometown. Since we're approximately the same age, did we go to high school together? THSVHS '89
 
Actually from a small town in Kansas. Wife is the native but she graduated from Terre Haute Baptist School. We met and married in North Dakota of all places. All four of the kids went to North. We've lived in Terre Haute off and on since we married.
 

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