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

all your information is helping me SO much! all the things you guysare saying ive had swimming around in my mind.. the malabsorption issues, the DS later as an option. My gut is telling me to have the sleeve. to not be "greedy" ... you know the story about the puppy with a bone looking at his own reflection in the Water... i dont want to drop my perfectly good bone for the perceived bigger bone, just to be left empty handed. It has taken me so long just to come to terms with the decision to have the sleeve that i cant imagine at this point wrapping my mind around GB. ive wrestled with the possibility of complications taking me away from my family, wrestled with feeling selfish because of that, and i dont think i can allow myself to take on added risk.

thank you all so much for replying, the support and added perspective helps so much. i feel so much better than when i wrote the post earlier today. i appriciate you.

tricia

It is hardly emerging science, as this has been known for years, though they are still trying to fully understand the mechanism involved. When my wife had her DS 6-7 years ago it was thought that the intestinal rerouting was responsible for the success in resolving diabetes - there is certainly more to it than simple weight loss or enforced dietary changes as many see their diabetes resolve at the outset. As noted by others, the DS also resolves diabetes, and at a rate somewhat better than the bypass (on the order of 98+% for the DS vs around 90% for the bypass from the figures I've seen), however, the sleeve has also been showing good success at early resolution of diabetes, so the docs are now hypothesizing that there are hormonal changes involved with the stomach changes that are also influential on the diabetes front (that is the more emerging science.)

It is certainly understandable that your doc advises that you go with the bypass, although how much of that preference is technical/scientific and how much is liability concern would be uncertain. (Put yourself in your doc's position - he may believe that the sleeve is the better choice for you overall, but the bypass has a longer documented history of diabetes resolution than the sleeve, so the bypass is the more legally defendable position should your diabetes not resolve. Unfortunately, defensive medicine is a fact of life in our society.)

A further complicating factor in your decision making - (my wife was a type II diabetic, treated for around twenty years and nearly at the end of med only treatment for its control when she had her DS) my wife's doc told her that in his experience, the longer one has had or been under treatment for diabetes, the longer they typically take to resolve post-op, which is why hers took around nine months or so to resolve while others walked out of the hospital with it resolved (and yes, there will be long termers who resolve quickly and short timers who take a while to resolve, but on average that relation holds). This implies that the longer you have had the diabetes, the stronger the tool needed to resolve it, so if you are a long timer with it and seriously want to resolve it, then the DS should also be under consideration.

So, research, research research this to become comfortable with it. As noted by others, the sleeve is having good success at resolving diabetes, but doesn't have the hard data behind it yet. The bypass may be better (and the DS better still,) but has more hard data to show for it. Not an easy decision, but good luck with it.

Hi dreamkin,

I'm not trying to discourage or second guess what your doctor said. But in my experience before the surgery, I consulted with three doctors, and found mixed opinions on what kind of surgery to undergo. But they were all uniform in one thing - they all said that I'm suitable for either kind of surgeries, but they would NEVER recommend GB IF I have problems in committing to take the nutrition meds (Vitamin, Iron etc). I'm so not good with these meds. And they told me that missing a couple of doses is not an option because the effects would be immediate making me tired and lethargic. That was a major factor in my decision to go with VSG.

HOWEVER, yours is a completely different situation. In my research before the surgery, I heard that VSG too had a history of 'curing' diabetes - but to a smaller extent than GB. It is all upto you, really. You can check with a few other doctors and then decide. And as rootman said, you can always get a GB if the VSG was not very successfull on the diabetes front.

All the best with your research and surgery!