I would like to post a question.

[Guest guest]

hi! my name is Deanna and I'am considering wls I would like to know if anyone

in the group had vbg? And what the pros and cons were. I'am 28 and have a 8

year old son...and would like to have the surgery soon to have another child.

Any info anyone can give would be greatly appreiciated. Thanks, and good luck

to you all.

[Guest guest]

> hi! my name is Deanna and I'am considering wls I would like to know if anyone

> in the group had vbg? And what the pros and cons were. I'am 28 and have a 8

> year old son...and would like to have the surgery soon to have another child.

> Any info anyone can give would be greatly appreiciated. Thanks, and good luck

> to you all.

Deanna--

Please, please do some research before deciding on the VBG. That is a purely

restrictive operation, meaning it is designed to make the stomach smaller and

nothing else. In strictly restrictive operations, there is a huge problem with

late weight regain since the body will soon adapt to the little you can eat and

slow down your metabolism accordingly. In addition, people who have had the VBG

claim that there are two main problems: they have to chew food to much and

elimate any foods that can't be pureed (meaning all meat, usually), and they

don't ever fill up the large stomach that's left untouched, so they never feel

satiety. That means they are hungry all the time! The foods you've been able

to

chew to mush drip slowly from the " pouch " created by the band to the rest of the

stomach so you can " get around " the surgery by drinking high-calorie liquids,

among other things. People who have had the band say they soon live off very

few

" mushy " foods and vomit and eat all the time. Because of all the problems with

the gastric banding, procedures were developed that shrink the stomach AND

bypass

some part of intestine. The intestinal bypass is what is going to maintain your

weight loss, as some of the food you eat won't be asorbed.

The VBG (and other gastric bandings) were introduced over 50 years ago, I

believe, and have had soooo many problems. There are much better surgeries out

there, though they will be more invasive (meaning bigger incision and more

organs

messed with). The RNY (Roux-en-Y gastric bypass) has been the standard since

its

introduction in 1969, and you can usually find a surgeon who will taylor the

intestinal bypass for each patient, meaning that once you are well-informed you

can make the decision of how much intestine you want taken out of the digestive

tract. (A proximal bypass only leaves a little bit out, so there's a greater

chance of regain. A distal bypass leaves out a lot, but you have more problems

like protein and calcium malabsorption and you will have to be vigilant in

taking

vitamins for the rest of your life.) A RNY will leave you with only a small

(2-4

oz.) stomach " pouch " without pyloric valve to facilitate gastric satiety and

emptying.

The DS is the newest surgery to come about, put together by Dr. Hess in Ohio in

1988 from the old biliopancreatic diversion (BPD). The Duodenal Switch cuts the

stomach along the greater curvature leaving the pyloric valve at the end of the

stomach in place, which means there's larger gastric volume and no dumping

syndrome. Satiety signals come very strongly after surgery though you can eat

twice or three times what an RNY patient does. The " restrictive " partial

gastrectomy is coupled with a different kind of intestinal bypass, kind of

difficult for me to explain right now. You need to go to duodenalswitch.com for

pictures and a complete explanation.

I'm 29 and pursued WLS also because I was found to be infertile. After a year

of

research and talking with several surgeons (one of which I finally went with

because he offered both the RNY and the DS and was the only one who could talk

with me intelligently about the differences between the two without prejudice) I

decided on the DS, believing it was the correct choice for my body. I did not

want my chunky four-year-old daughter to grow up knowing that the only way Mommy

can maintain a decent weight is to eat tiny portions for the rest of her life.

Also, the surgeon I consulted with many times discussed post-op pregnancy with

me

and said that he likes patients to rely on whole foods instead of vitamins and

supplements for the rest of their lives. With the larger stomach of the DS, I

would be allowed much more variety in what to eat and would be able to

manipulate

my vitamin and protein intake much better. (For example, if my routine

bloodwork

discovers that I am anemic, I can add a whole food rich in iron to my diet, such

as an extra piece of steak a week, or a handful of raisins a day, instead of

having a prescription iron pill which is extremely difficult to absorb and must

be taken on an empty stomach with acidic juice, etc. A RNY patient may not have

enough room in the tiny " pouch " to eat more.) I am three months out and very

happy with my decision.

There is such a difference in how different surgeons " do " their surgeries,

though; some make the RNY pouch larger and some smaller. Some bypass a lot of

duodenum (the first part of the small intestine--also the area which absorbs

most

of your iron and calcium) and some only a little. Success rates for the RNY

stand at 65-75% of excess weight lost; rates for the DS are 75-85% excess weight

lost (because there is greater intestinal bypass in the DS.) A lot of surgeons

don't know much about the DS and will claim that it's " too risky " ; my surgeon

believes that it's less risky than a distal RNY because the larger DS stomach

makes up for most of the malabsorption risk. He also told me that if I wanted

to

become pregnant after surgery he would recommend the DS, for the reasons

mentioned above. I eat a regular diet, about 1/3 of my pre-surgery portion size

(at two months out, that is; my stomach will continue to stretch for the first

year or so), and must take a multivitamin every day for the rest of my life.

I firmly believe that there are quite a few choices for us in this day and

age--the RNY is still being performed widely because it is an excellent surgery

with good results and not much risk and works well for huge numbers of people.

The bands, on the other hand, probably should not be offered anymore because of

the ridiculous risks associated with them that are eliminated by the other

surgeries offered. (Risks like stoma obstruction, band slipping, adhesions that

grow into stomach tissue, stoma closures because of scar tissue, lack of

satiety,

chewing food to much before swallowing, very high rate of vomiting--even years

afterward.)

Please do your research and find out about all the surgeries offered now: a

good

place to start is obesityhelp.com or duodenalswitch.com. Here on egroups there

are tons of other OSSG (obesity surgery support groups) that deal with revisions

( " ossg revisions " and " DS--revision " I believe are two) which is people who have

had VBG's and are now going under the knife again to be " revised " to a different

surgery--either the RNY or DS. There are also egroups for specific surgeons and

surgeries.

Good luck on your research! This is a great time for you to pick and choose

exactly what you want to accomplish with your surgery and what side effects you

are willing to live with. There will be a surgery out there for you, and some

time soon we will be hearing about your new pregnancy!

Love,

Jill H (Los Alamitos, CA)

lap DS / Dr. Welker (Portland, OR)

9/27/00

BMI 45

3 months--45 pounds gone forever!