Advice on whether to pursue VSG. BMI 35. Orthopedic disaster.

[s2dm 3]

Hi,

I'm really torn about what to do and could use some advice from folks that have been down this road. I'm 44, Male, 6'6" tall, weight around 288. I've been a little overweight all my life, played college basketball, but in the two years after I quit playing, I went from 230, still a little heavy, to 290. I peaked at 305 during medical school. After some traumatic life experiences, I dropped a ton of weight through diet and exercise, getting down to 230 at one point, around age 32. By 34, I was back to 270, then from 36-40, managed to stay around 245-250. Over the last couple years it has crept back on and I'm feeling desperate. My weight is on my mind most of the time every day and I feel desperate and powerless to make changes.

My ideal body weight is under 215lbs, but my body feels pretty good and I can be active at 240, which would be close to 50lbs to lose. I've had two liposuction surgeries, which really only provided a visual difference for a few months. Lately, Ive been doing two week stints at hiking and nutrition retreats at a pretty high $ amount. I generally lose 15-20lbs, but it comes back in the month or two when I get home and I feel worse about myself for failing.

My energy is basically gone, I have a hard time handling work and I have zero sex drive which my GF really struggles with. In the last year, my feet, ankles kness and back have gotten so bad that many days when I get home from work I just lay down, put on ice packs, and don't get up again until the morning. They always feel better for a few months after I get back from the hiking retreats and lose weight, but lately they have been so bad I can't even do that. I've also noticed that my blood pressure and resting heart rate are creeping up.

To look at me, I'm just a really big guy, obese by the numbers, but most wouldn't call me that visually. But my underlying frame is lithe, and really has a hard time supporting this weight. I've invested probably 40-50k already in weight loss supplements, Lipo, retreats etc. While I'm not morbidly obese yet, and I don't have the more serious co-moribities like Diabetes or heart disease, I feel like my weight is a very negative force in my life. I'm depressed, in pain, and just feel like I'm on a bad course and still young enough to really do something about it.

Sorry for the diatribe above, but it was therapeutic to explain where I am coming from in terms of considering the sleeve vs something less invasive. I'm really ready to make a major change in my relationship with food and my body, and I really want to get back to all the things I used to like surfing and hiking.

I've considered less invasive things like balloon, but It feels like a half measure I would fail once it was out. And for a variety of reasons, the band is unappealing (the fills and having something foreign in my body just really turns me off). I know my constellation of problems wouldn't be covered by insurance, but am fortunate that the cost of self pay wouldn't be at all prohibitive.

Am I crazy for considering this?

Edited March 30, 2017 by s2dm

[YeaMe 246]

I was exactly in your same spot, though I had kept some of my weight off.

I am 56 years old and through the years, I have lost and gained the same weight over and over. In 2014, I started having problems with my feet/ankles and I was miserable and in constant pain. In Jan. 2016, I decided, this is it. It's now or never. So I went on WW and quickly shed 50 lbs. By the end of 2016, I started putting the weight back on.

It has always been hard to share with friends/family what goes on in a brain like ours. I thought about my weight every day, all day. It's a horrible roller coaster of emotions.

In January 2017, I woke up one morning and thought to myself, this will stop now! I called a friend to had bariatric surgery and within a week I had an appointment with her surgeon. I knew my insurance wouldn't pay for it because I was basically a "healthy" fat person and since I had lost some of the weight (280lb down to 232lb), my BMI was too low anyway. I decided it would be the best $15,000 ever spent. I ended up only having to pay about $8,000 out of pocket because I had a hiatal hernia fixed at the same time.

I have only told my daughter and best friend, and they are both supportive. I didn't want to hear from others - Oh, you have been doing so well on your own, why have surgery?!?!

On 2/15/17 I had the surgery and am down 30 lbs to 202 and feel great. I can say now, the best money and decision I have ever had. I had literally no pain from the surgery (just nauseous for 3 days). My surgeon told me most doctors aren't doing the band (and he won't) because the failure rate is so high.

Really, only you can make the decision on your surgery. I just knew I couldn't live like I had been for the last 20 years. Good luck with your decision.

Edited March 30, 2017 by YeaMe
additional info.

[s2dm 3]

12 minutes ago, YeaMe said:

I was exactly in your same spot, though I had kept some of my weight off.

I am 56 years old and through the years, I have lost and gained the same weight over and over. In 2014, I started having problems with my feet/ankles and I was miserable and in constant pain. In Jan. 2016, I decided, this is it. It's now or never. So I went on WW and quickly shed 50 lbs. By the end of 2016, I started putting the weight back on.

It has always been hard to share with friends/family what goes on in a brain like ours. I thought about my weight every day, all day. It's a horrible roller coaster of emotions.

In January 2017, I woke up one morning and thought to myself, this will stop now! I called a friend to had bariatric surgery and within a week I had an appointment with her surgeon. I knew my insurance wouldn't pay for it because I was basically a "healthy" fat person and since I had lost some of the weight (280lb down to 232lb), my BMI was too low anyway. I decided it would be the best $15,000 ever spent. I ended up only having to pay about $8,000 out of pocket because I had a hiatal hernia fixed at the same time.

I have only told my daughter and best friend, and they are both supportive. I didn't want to hear from others - Oh, you have been doing so well on your own, why have surgery?!?!

On 2/15/17 I had the surgery and am down 30 lbs to 202 and feel great. I can say now, the best money and decision I have ever had. I had literally no pain from the surgery (just nauseous for 3 days). My surgeon told me most doctors aren't doing the band (and he won't) because the failure rate is so high.

Really, only you can make the decision on your surgery. I just knew I couldn't live like I had been for the last 20 years. Good luck with your decision.

I have a really big hernia as well, I'll ask about whether I can bundle them into one procedure.

@YeaMe what has been the hardest part for you so far?

[YeaMe 246]

The hardest part was realizing that at the beginning 3T of food was enough. Also that you will be probably eating nothing but Protein for awhile because you can fit in so little. So, I'm missing fruit and salads, but just have to realize there will be a time I can eat those again. I'm 6 weeks out and now on "normal food" (which is protein in a solid state). I'm up to 2-3 ounces of protein at a time so meal planning is really, really easy. My surgeon said for the first 6 months I could live on protein, his prescribed Vitamins, and Water with no problem. I have though lost connections with some friends because our social time was eating and drinking. I'm okay with that - I will find new friends at the gym!

My greatest feeling, is not having the food cravings. My body was addicted to processed foods, sugar, diet Coke, and basically anything that was bad for you. It's soooooooo freeing! I have gone out to dinner and watched others eat Mexican food (my love) and drink beer/margaritas, and I am as happy as a clam eating some protein off a friend's plate and sipping my water.

I think the one most important factor in the process, is picking out a good surgeon, even if you have to pay a lot more. That will be a big factor in the success of the surgery.

Just let me know if you have any other questions. If you were my friend, I would say the only regret you will have is not doing it sooner.

[s2dm 3]

The surgeon I am considering is Helmuth Billy, who seems to have really good reviews, though I haven't done an exhaustive search on him yet.

[Berry78 4,261]

Not crazy at all. Sounds like you are a prime candidate! Sleeve is a good choice.

[1poundatatime 174]

I don't think it's crazy at all.

I started out with a BMI of 40 (but I doubt anyone would have guessed it was that high). I am otherwise healthy, but I figured I can't count on that forever. As I gain weight and get older, things like hypertension, high cholesterol, diabetes, arthritis, etc are bound to start cropping up. Plus, I had to look at how likely I was to even stay at my current weight... The trend has always been to gain.

I'm two weeks post-op now and have lost a total of 35 lbs (23 pre-op and 12 post). I already feel like a new person. I truly feeling lighter, more agile, and more like "me".

Do look into it. Research doctors. Read lots about the post-op process and be 100% eyes-open about what you're signing for.

I suppose it isn't for everyone, but it certainly can be life-changing!

[kidchick 43]

This is a very helpful post - I don't "qualify" for WLS either - bmi too low and 50 lbs overweight by the charts but I feel the same way - it's not going to get better and I have a very bad back and am unable to do a lot of weight bearing exercising (per doctors orders) so the weight is just not coming off. I appreciate this info and this site so much - I'm new but learning so much and am so encouraged by the responses on this post. I stopped telling people my back doctor referred me for WLS because they think I'm ridiculous for even considering the possibility. The truth is, I don't want to live in pain for the rest of my years if I can do something about it!

[FunkyMunkyBrat 205]

I think it's a very smart idea.. You already are having issues with your joints no point in waiting till you're totally disabled by it.. I wish I hadn't waited so long.. Just remember you have to wrap your head around this lifestyle change or it's not going to help.. Its only a tool not a cure
Wish you the best!

Munky

[Licia'sjourney 89]

I had the sleeve surgery 06/2015 and I dont regret it at all. I'm sure its the main reason I havent regained all the weight back.

However, now that I am 2 years out I can eat a lot more and I am working just as hard now as I did before the surgery to maintain the loss I have had and I am still trying to lose the last 30-40lbs. I am 58 so there's that.

I would like to suggest you read The Obesity Code by Dr. Jason Fung before you make your final decision. He makes so

much sense in what he talks about. I wish I had come across this book sooner but I still dont regret the surgery.

[s2dm 3]

Thanks for all the advice everyone. One day post op, should be going home soon.

First night was pretty rough, but as others have said, getting up and moving was key.

[YeaMe 246]

Congratulations on your surgery!

[DeezUU 28]

I'm pre-op for RNY (hopefully in about 2/3 months). Started at 285lbs/5'11" with a BMI over 39. Similar story... I've always been able to hide it well (been hiding it all my life). I've always been a 'bigger guy' since I was about 13. Of course, I'm getting the "you don't need surgery" from a few people but most are very supportive. I was worried my folks wouldn't be on my side but they are behind me every step of the way. My knees are tired of carrying this weight and are begging me to lighten the load (and I climb utility poles for a living so those poles are begging me, too). I'm currently down 22.8 lbs thanks to the great dietary guidance my program is offering. I qualify thanks to apnea (in the extreme-severe range) and I can not wait to be rid of it and that damned CPAP!!!

Congrats on your sleeve! Can't wait to be on that side of the surgery table.

[s2dm 3]

23 minutes ago, DeezUU said:

I'm pre-op for RNY (hopefully in about 2/3 months). Started at 285lbs/5'11" with a BMI over 39. Similar story... I've always been able to hide it well (been hiding it all my life). I've always been a 'bigger guy' since I was about 13. Of course, I'm getting the "you don't need surgery" from a few people but most are very supportive. I was worried my folks wouldn't be on my side but they are behind me every step of the way. My knees are tired of carrying this weight and are begging me to lighten the load (and I climb utility poles for a living so those poles are begging me, too). I'm currently down 22.8 lbs thanks to the great dietary guidance my program is offering. I qualify thanks to apnea (in the extreme-severe range) and I can not wait to be rid of it and that damned CPAP!!!

Congrats on your sleeve! Can't wait to be on that side of the surgery table.

I got alot of that as well. The radiologist at the barium swallow, both of my pre-op nurses right before surgery "really? You're getting a sleeve?"

For me, it was as much preventative as anything else, I could see the path I was on didn't end well.

[kidchick 43]

Thank you - I just ordered it from Amazon for my kindle - I'll begin reading it tonight!