Ok So My Surgeon Has Me Second Guessing My Choice...

[dreamkin 4]

I had my initial consultation yesterday wth Dr. Yu in houston. He was very nice, and patient. He took time to talk to me and listen to me... which i greatly appriciate. i know he is an amazing surgeon. ive done my research and have a friend who is a surgeon look into him for me. i know he will definitely be my surgeon.... Then he threw me a curve ball.

He said that while 70% of the surgerys he does are for single incision VSG, he would prefer i have GB. ??!?!?!!!?!!?

he says there is science emerging that says GB is basically curing diabetes. not the weightloss, but the actual surgery. He says the rerouting of the intestines effects glycogon (sp?) and in a significant number of patients, diabetes is being reversed before they even lose much weight. I have been diabetic almost my whole life, and would love to be free of the fear of future related complications.. but im TERRIFIED of GB. he assures me that it has changed completely from 10 yrs ago. the risk is nearly the same as sleeve, with few long term complication possibilities as long as im compliant. he says he truely believes it is what is best for me. I was 100% set of VSG. now im about 80% set. i know i will have to do my own research, and soul searching... but i just wanted to reach out and see what your thoughts are.. anyone been through this? any input is so appriciated. im slightly freaked out, slightly confused.

i will have my nut class and psych eval march 8 (thats all my insurance requires) and my endoscopy that same day. looks like surgery will likely be early april.

thanks!

tricia

[Bedhead 158]

Do you have Type 1 or Type 2? You said almost all your life so I'm thinking Type 1- which no amount of surgery will cure

[Rootman 1,101]

You are in a real hard spot. I did NOT want a GB because I did not want the malnutrition and malabsorbtion issues. Both my sister and brother had GBs and both are reliant on high doses of Vitamins and MUST take Protein supplements. I've had a VSG and do take Vitamins but have never had a single bad test showing me to be deficient in anything. I've lost 170+ pounds and have no health issues that made me seek WLS in the first place. I was NOT diabetic to my knowledge but I was having trouble keeping my sugar levels steady, I would actually get HYPOglycemic, too low a sugar. Now I don't. The jury is out as to the FACT that ANY WLS "cures" diabetes or simply causes weight loss that CAUSES diabetes.

You are going to have to make a tough decision. Remember that you can always get a GB AFTER a VSG because nothing is rerouted. A GB IS reversible but risky and to do a reverse and THEN a VSG is probably out of the question. The VSG started out as the first part of a procedure and was followed up by a Duodenal Switch gastric bypass, so it still can be done that way.

I wish you well friend, you've got a tough decision.

[dreamkin 4]

thanks for the reply rootman... i was thinking the same thing about having the re routing later if i still wanted. its a valid argument that i was too taken aback to come up with at the time of my consultation. im making a written list of questions fo my next appt. it is a tough choice.

bedhead... i am a juvinile type 2 diabetic. i do take insulin now, because it has progressed to that point. i got type 2 diabetes at age 6, at was at a normal weight at that time... weird i know. the surgeon is aware of that weirdness and has said that my particular case may not be helped by GB.. but that he feels its my best shot at even having a chance of ridding myself of the disease. he didnt sugar coat it all make it sound 100% rosey. he just wants me to know that in his opinion its my best hope.

[Dooter 1,457]

I had my initial consultation yesterday wth Dr. Yu in houston. He was very nice, and patient. He took time to talk to me and listen to me... which i greatly appriciate. i know he is an amazing surgeon. ive done my research and have a friend who is a surgeon look into him for me. i know he will definitely be my surgeon.... Then he threw me a curve ball. He said that while 70% of the surgerys he does are for single incision VSG, he would prefer i have GB. ??!?!?!!!?!!? he says there is science emerging that says GB is basically curing diabetes. not the weightloss, but the actual surgery. He says the rerouting of the intestines effects glycogon (sp?) and in a significant number of patients, diabetes is being reversed before they even lose much weight. I have been diabetic almost my whole life, and would love to be free of the fear of future related complications.. but im TERRIFIED of GB. he assures me that it has changed completely from 10 yrs ago. the risk is nearly the same as sleeve, with few long term complication possibilities as long as im compliant. he says he truely believes it is what is best for me. I was 100% set of VSG. now im about 80% set. i know i will have to do my own research, and soul searching... but i just wanted to reach out and see what your thoughts are.. anyone been through this? any input is so appriciated. im slightly freaked out, slightly confused. i will have my nut class and psych eval march 8 (thats all my insurance requires) and my endoscopy that same day. looks like surgery will likely be early april. thanks! tricia

Maybe a couple of consultations with other surgeons would confirm something one way or the other, as a second or third opinion kind of thing. Even if you still go with Yu....you could get input from other docs. (?)

[dreamkin 4]

Thanks dooter, i actually JUST had a conversation about this with my surgeon friend and she said the same thing. ill need some more info, and opinions before i can be confident in any decision i make.

[linkybo 27]

Hi Dreamkin,

I heard a similar thing at the information night I went to. I walked in the door, knowing I wanted a sleeve and the surgeon talked a lot about GB and the band, and just barely mentioned the sleeve procedure. When I specifically asked about it, he said it was the "new kid on the block and getting a lot of hype." He prefers to do the GB because, in his words, if you have diabetes or if you've ever had acid reflux, the GB fixes those.

I'm with you, though, I think the sleeve would fix them, too, and with less complications. Maybe not immediately fixed, but when you lose weight, they should get better, right?

I love how the sleeve is kind of a happy medium between the band and GB and I'm still wanting to go that route. Good luck!

[andi0120 41]

I was in a pretty similar situation. My diabtes is pretty bad. My BMI is not that high but the diabetes got me approved. My doctor said the same thing about diabetes reversing. I had a hard decision to make but after A LOT of research I decided to go with the sleeve. I'm really scared of the side effects of gbs. I did find out that there is a huge chance of diabetes getting better with the sleeve. I think overall its a personal choice. My last visit my doctor said he's confident my diabetes will improve. My surgery is 2/29. Check in for updates. Praying for good results. Do your research and talk to another doctor.

[dreamkin 4]

losing weight can only help my diabetes. GB offers the possibility of curing it. My surgeon wanted me to choose BG but said that most his surgeries are VSG. he added that like 3% of the surgeries he does in his bariatric practice are the band. He said its a useless and ineffective procedure. hes clearly not pro-band.

the sleeve feels like a happy medium to me too... most of the benefits, only a fraction of the risk. sigh... what a decision.

[andi0120 41]

Yea I know that there is a chance it could cure my diabetes my primary doctor really tried to get me to do it. But honestly I guess I read to many horror stories online and it scared me. I called back and actually changed my procedure. It was a hard decision to make with a lot of praying involved. I know now that my diabetes may not go away completely but I'm hoping to be no longer insulin dependent.

The side effects of gastric bypass scared me. The dumping syndrome alone was enough. Good luck with your decision.

[Rootman 1,101]

One thing I failed to mention that scared me sh**less about a GB was the fact that the stomach is left largely intact but pulled to the side, the connection is severed just below the esophagus and the first part of the small intestine is severed and re-routed. Not only did the fact that my digestive tract would be severed TWICE scare me but the fact that my (largely) intact stomach would NOT be readily accessible to a scope should I have MORE stomach problems - and I've had ulcers. To inspect the stomach they have to use an extra long scope go through the pouch down into the intestine make an abrupt turn and go back up the stub of intestine (duodenum) into the stomach. My sis who had a GB started bleeding from her stomach and they could not find it right away because they hospital she went to lacked the equipment to scope her.

YES an GB does cure GERD as the acid producing stomach is completely detached from the esophagus, so no acid is splashed up into it because little is produced in the pouch. The pouch is made up of the very tip of the stomach and a portion of the small intestine that is cut and folded to make a wider area.

Also, look up DUMPING SYNDROME as you WILL have it with a GB. Sleevers - indeed ANYONE with a FULL stomach - can dump but GB patients are practically guaranteed to have it.

[linkybo 27]

And GB people tend to talk a lot about slime? Hmm.. never looked it up, but pretty sure I don't want that!

[kemo46 82]

Rootman is right, the way of life for MOST GB patients is high maintenance. My sister had successful GB surgery 6 years ago. She lost the weight and kept it off and it did cure her diabetes. Her way of life though is horrible. She has major malabsorbtion issues, horrible dumping issues and does not look healthy. She is a nurse and does follow all the rules but the amount of Vitamins and Protein she has to have is a lot. What might agree with her food wise one day, will not the next day.

I had the sleeve in May of 2011, I have lost over 110 lbs and I take no medication. My diabetes is controlled as well, my blood sugar numbers are normal and my last A1C test was 5.5 . The question I would ask your doctor is what his numbers look like post surgery for his sleeve patients and has their diabetes become under control. As you know, sometimes diet and losing weight will not reverse the effects of Diabetes, sometimes your body just will not produce enough insulin. I would hate to see you do the bypass as your 1st choice and your diabetes still be an issue. I am not a Doctor but as listed above, I do have experience with both surgeries with Diabetes being the common denominator. Good luck on your decision, it is not an easy one.

now

[Rainydayz 27]

My surgeon said the same thing about the bypass curing diabetes. But since I didn't have it he didn't push me to get a bp, but he said he does recommend it for those who do. Something about the mechanics of rerouting your guts - not just the weight loss, causes the remission. I admit I didn't pay close attention since my mind was made up about the sleeve and I'm not diabetic. I chose the sleeve because I just didn't want to put myself at risk for deficiencies. I'm not the world's best vitamin-taker and you have to take so many with the gb. I'm barely able to keep up with what I take now.

But you should probably keep gathering information and talking to more doctors. Good luck whatever your final decision is!

[circa 333]

GB is being proven to cure diabetes, but so is the DS, which, the VSG is the first part of. Most sleeve patients reverse their diabetes with the improved health and weightloss, and if it doesn't, you always have the option of going with a DS. I'm a firm believer in going with your gut.

I have a person issue with the re-routing of the digestive system and leaving the unused portion of the stomach in place - that's the part that's not working - why wouldn't you take it out???

While I understand that GB is reversible, the main reason for reversing it is complications due to the rerouting. It sounds like trying to put tennis shoes on a goat - sure, it'll keep his feet from getting the carpet dirty, but keeping him out of the house will do the same thing. All that extra stuff for the same basic result.

For some people, GB is necessary - they're not a good candidate for the sleeve. Some people NEED dumping syndrome. Some people have other issues that would cause the sleeve to not work for them - these are typically psychologically related.

Personally if your insurance covers the sleeve, I would think they cover the DS. Have your surgeon book you for a DS, then decide later if you're going to have the second part of the procedure, should you need it.