[volleyball]

Jill, you do seem to be looking at this with your head on straight. I am of the mindset that Jan has and it may be one problem for another. And for us overweight people, the diabetes is that nagging thing on our shoulder telling us to eat better and exercise more. You'll have scarring and loose skin with the surgery.
The surgery forces you to eat little when you have a tiny stomach. Have you though of that Alli or Ali stuff that gives you the runs if you overeat? That may be a good 90 test to see how you do. A little noninvasive way to see if you can handle it. And if it works, you may be tempted to continue with it. Then get more active.
Taking steps to change your life will benefit you either way whether surgery or not. There doesn't seem to be the follow up care built into the surgery procedure to make sure the patient lives a healthy life. That explains why so many patients regain so much of the weight. As a young person, you have a long time to live with your decision. I just wish for you to make the right one for you.

[jillybean]

Originally Posted by volleyball

Jill, you do seem to be looking at this with your head on straight. I am of the mindset that Jan has and it may be one problem for another. And for us overweight people, the diabetes is that nagging thing on our shoulder telling us to eat better and exercise more. You'll have scarring and loose skin with the surgery.
The surgery forces you to eat little when you have a tiny stomach. Have you though of that Alli or Ali stuff that gives you the runs if you overeat? That may be a good 90 test to see how you do. A little noninvasive way to see if you can handle it. And if it works, you may be tempted to continue with it. Then get more active.
Taking steps to change your life will benefit you either way whether surgery or not. There doesn't seem to be the follow up care built into the surgery procedure to make sure the patient lives a healthy life. That explains why so many patients regain so much of the weight. As a young person, you have a long time to live with your decision. I just wish for you to make the right one for you.

Thanks, volleyball!

The type of surgery I am looking to have is different from the regular gastric bypass most people know of. The duodenal switch (DS) does not make a tiny pouch out of your stomach like the gastric bypass (GB) does. Instead, it makes a "sleeve," sort of a banana-shaped stomach that still functions like a regular stomach, pyloric valve and all (unlike the GB). Most people who have the DS can go on to eat "normally" after the surgery, including carbs, sweets, fats, etc., and still maintain their weight loss. That's not to say you can't regain, but regain with DS is much less common than with GB.

Alli is a fat blocker--it will aid in eating low fat, not necessarily low carb. When you eat too much fat, it comes out as an orange oily substance. You could probably still sit and eat a bag of fat-free sugary candy, though, without a problem!

Having diabetes for the next 40+ years would be **** on my body. As it is, eating low carb, exercising, and taking 1500mg metformin and 50 sitigliptin, my sugars are not ideal.

I had about 2 hours of very tingly fingers the other day. It scared the **** out of me. I can't help but to think it was related to the diabetes--early sign of impending neuropathy, maybe?

Scars and loose skin are the absolute least of my worries. I already have an abdominal scar from my belly button all the way down from the removal of a 10-inch ovarian cyst at age 16. I'm not doing this because I think it'll alow me to wear a bikini next summer--I know that having been overweight my whole life already, even if I lose the weight slowly and healthfully, I will have loose skin. Heck, I already have saggy upper arm flaps and a pannus (yes, it's lovely, I know!). There is no looking good naked in my future regardless of what path I choose

The surgeon I'm hoping to have requires follow-up checks at 3 months, 6 months, 1 year, and every year after that. These include annual blood work to check all nutrient levels for deficiency plus regular bone scans to check for bone loss.

Diabetes scares me more than surgery--I suppose that's the bottom line. If surgery can make me kick the diabetes, lose weight, have healthier pregnancies, and exchange the medication for nutritional supplements, the trade-offs are worth it to me

Hair grows back. Incisions heal. Saggy skin is concealable under clothes. Beta cell don't regenerate. Amputated limbs don't grow back.

[Samantha]

Seems you have really did your homework on this and I cansee why you want the surgery . I wish you the best of luck . Let us know when you go in and we can all say a prayer for you, i think that helps .

[jillybean]

Originally Posted by Samantha

Seems you have really did your homework on this and I cansee why you want the surgery . I wish you the best of luck . Let us know when you go in and we can all say a prayer for you, i think that helps .

Thanks! I will be quite a whole still since my insurance requires I do 6 months medically supervised diet before approval. As if I haven't already dieted for more than 6 months of my life...

[volleyball]

I heard that they want you to diet beforehand, I guess it was to show your commitment. I guess they are hoping that the ones who diet appears to be working will cancel the surgery and save them the money.

[jillybean]

Originally Posted by volleyball

I heard that they want you to diet beforehand, I guess it was to show your commitment. I guess they are hoping that the ones who diet appears to be working will cancel the surgery and save them the money.

Some insurance companies require supervised diet before surgery, some don't. Studies have shown it doesn't make a bit of difference for the patient as it related to post-op diet adherence/commitment. Personally, I think insurance companies are hoping that if they make people wait another 6-12 months (some do require 12 months), then some will get impatient or won't meet the requirements and end up not having the surgery. It's all about the Banjamins, baby!

Although, being obese and diabeteic for a lifetime could end up causing the insurance companies even more than an inpatient surgery. But of course, they see the big one-time expense and think it's too much...

Anyway, it looks like I won't be able to start my supervised diet until net month, so I won't be able to even submit to insurance until that's done (February), then wait for insurance response (anywhere from 24 hours to a month), then appeal if denied or approved for the wrong surgery, then schedule an operation appointment...it'll be a while.

But that's okay--I'm probably going to start going to WLS support groups next month so I can hear other patients' stories, advice, etc.

[verynicebecky]

Hi Jill!
I too am looking to have weight loss surgery due to both my weight and my diabetes. I joined this forum back in Dec (I think), the month that I began thinking of switching over from oral diabetes meds to insulin. My liver enzymes had shot up and an ultrasound revealed fat on my liver.I just came over here to see what was going on and stumbled across your thread. When I began the insulin back in January I began to research WLS on liver transplant recipients (obesity and diabetes is common in liver transplant recipients) and I came across a wonderful support group called thinnertimes, so that is where I have been hanging out. A lot of ppl there who were diabetic before surgery are now off of their meds. In fact I can't think of a single person over there who is still on meds, since their surgery. Some ppl can immediatly give up the meds...for some it takes a few months, and I know of two ppl who actually had to begin injecting insulin immediatly post op (my guess is trauma of the surgery caused their bs to rise) but they are now off of any diabetic meds. Someone mentioned the Vertical Sleeve Gastrectomy. Yes, that is a really kewl procedure and what I want actually but my insurance (Tricare) won't pay for that and the VA (I am a Vet and trying to get this done thru the VA) doesn't do it.
Anyway Jill, just wanted to say hi and wish you well with this. Where are you in your journey?

[jillybean]

I'm actually beginning my 6 months medically supervised diet this week (required by insurance before approving me for surgery). So, it will be at LEAST 7 months before I can actually have the surgery.

I met a woman over the weekend who had the same surgery I'm hoping to have. She was on 4 different diabetes medications prior to the surgery (she was type 2), and is now down to only Metformin. Her last HBA1C was 5.4, so her doc said if her next one is still below 6.0, then she can stop the Metformin, too.

[verynicebecky]

Hi Jill,
The VA does not require the 6 month diet. They do require that you attend their weight managment classes for at least three months. I am just waiting for my psych. evaluation and then I can either wait for the VA to do this, or I can use my Tricare insurance and go civilian. I am going thru the steps but I still don't know for certain if I will get to have this surgery done. I have learned a lot though, going through the process. I wish you well!