Monday, September 25, 2006

Hello; I want to add the options that I had faced at that time. 1st option was dieting - not a very good option because I had done that and I really did loose the weight about 60 lbs. was the most at one time but being deprived of the foods that I liked worked for a while. Just like it was as my mother deprived me I had an even stronger desire to eat. The battle was lost again and the weight came back and more. The went on and on. I realized that the day I started the diet that I was strong and as the days went on I may not have a strong day and with the drive to eat because of the depriving I was doomed, another disaster. 2nd option, I went to the Dr.'s office and got some diet pills. I started taking them. They seemed to make me nervous and queezy. I realized that the pills were not for me. Including the side affects that I was jumping out of the fire into the fire. The 3RD Option I went to a clinic that gave you a diet plan that was a structured environment and gave medication to help loose weight. I choose this route without the medication. I lost weight without the meds. This was workings for me and I lost another 60 lbs. But we moved and I got tired of the foods that was deprived. The 4th option, I then started to check into the surgery. I realized that there were several options in this realm as well.

Vertical silastic Ring Gastroplasty (VSRG):
The VSRG is a much simpler operation that just makes a small pouch out of the upper stomach. The pouch is stapled off from the rest of the stomach except for a small opening, which is then reinforced with a ring made of silastic, a soft and rubbery but strong material. This operation achieves its weight loss solely through restricting intake, and its results are correspondingly less impressive than with the other two operations. A patient with a VSRG can expect an average of 60-65% of the excess body weight lost with this operation. Since the pouch can and does stretch somewhat over time, there is a mild weight regain aver the long term with this operation, but it still achieves greater than 50% excess body weight loss over the long term, on average.
This operation is good for people who are in the lower BMI ranges of 35-45. These patients can lose 60-65% of their excess body weight and still significantly reduce their co-morbidities. Many patients seek out this operation because they donÂ’t want the added risks that go along with the anastomoses required for the BPD/DS and RNYGB.
Side effects of this operation are mainly vomiting, which is usually once or twice a month early on, but can be more frequent. Leakage or staple line breakdown are unusual problems.

Gastric Restrictive Procedure – Vertical Banded Gastroplasty (VBG)
Vertical Banded Gastroplasty (VBG) is a purely restrictive procedure. In this procedure the upper stomach near the esophagus is stapled vertically for about 2-1/2 inches (6 cm) to create a smaller stomach pouch. The outlet from the pouch is restricted by a band or ring that slows the emptying of the food and thus creates the feeling of fullness.

Biliopancreatic Diversion (BPD )
BPD removes approximately 3/4 of the stomach to produce both restriction of food intake and reduction of acid output. Leaving enough upper stomach is important to maintain proper nutrition. The small intestine is then divided with one end attached to the stomach pouch to create what is called an "alimentary limb." All the food moves through this segment; however, not much is absorbed. The bile and pancreatic juices move through the "biliopancreatic limb," which is connected to the side of the intestine close to the end. This supplies digestive juices in the section of the intestine now called the "common limb." The surgeon is able to vary the length of the common limb to regulate the amount of absorption of protein, fat and fat-soluble vitamins.

Extended (Distal) Roux-en-Y Gastric Bypass (RYGBP-E )
RYGBP-E is an alternative means of achieving malabsorption by creating a stapled or divided small gastric pouch, leaving the remainder of stomach in place. A long limb of the small intestine is attached to the stomach to divert the bile and pancreatic juices. This procedure carries with it fewer operative risks by avoiding removal of the lower 3/4 of the stomach. Gastric pouch size and the length of the bypassed intestine determine the risks for ulcers, malnutrition and other effects.

Biliopancreatic Diversion with "Duodenal Switch "
This procedure is a variation of BPD in which stomach removal is restricted to the outer margin, leaving a sleeve of stomach with the pylorus and the beginning of the duodenum at its end. The duodenum, the first portion of the small intestine, is divided so that pancreatic and bile drainage is bypassed. The near end of the "alimentary limb" is then attached to the beginning of the duodenum, while the "common limb" is created in the same way as described above.

Combined Restrictive & Malabsorptive Procedure – Gastric Bypass Roux-en-Y
In recent years, better clinical understanding of procedures combining restrictive and malabsorptive approaches has increased the choices of effective weight loss surgery for thousands of patients. By adding malabsorption, food is delayed in mixing with bile and pancreatic juices that aid in the absorption of nutrients. The result is an early sense of fullness, combined with a sense of satisfaction that reduces the desire to eat.
According to the American Society for Bariatric Surgery and the National Institutes of Health, Roux-en-Y gastric bypass is the most frequently performed weight loss surgery in the United States. In this procedure, stapling creates a small (15 to 20cc) stomach pouch. The remainder of the stomach is not removed, but is completely stapled shut and divided from the stomach pouch. The outlet from this newly formed pouch empties directly into the lower portion of the jejunum, thus bypassing calorie absorption. This is done by dividing the small intestine just beyond the duodenum for the purpose of bringing it up and constructing a connection with the newly formed stomach pouch. The other end is connected into the side of the Roux limb of the intestine creating the "Y" shape that gives the technique its name. The length of either segment of the intestine can be increased to produce lower or higher levels of malabsorption.

If you have had or you are going to have a Weight loss surgery know which Kind you are having. There are so many people out there that really didn't know there were several surgeries. When you ask them which surgery did you have , they say gastric by-pass. But they don't know which type they had. The average person dosen't even know there are several types. You Have A Choice!!! Ask the Dr. until your satisfied with the answers that you get. Remember it is your body, You have a right to know as well as a choice, you will live with the decission afterward not the Dr.

Tomorrow I will tell you my choice and Why?


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