[Young Grasshopper]

Hi All,

Just received an email from someone raving about DS over RNY. Thought DS was considered out dated compared to RNY. Others say, RNY is more prevalent because DS is more complicated and expensive. Any advice? I have an appointment with my surg., pre-op, on friday and I'm writing up my questions. Pretty sure about the RNY but thought I'd ask about DS. Thanks!

Deb

[jiffypop]

yes yes yes!!! what pookie says!!!

here's what i know or have heard. first, i know two people who've had it. Dawnajoy, who posts around here is a star. she's done fabulously well with it and has all kinds of information. PM her. pick her brains. she's a great resource.

a friend who lives near me also had it. she's had lots of complications, and now that they're all taken care of and she's healthy, she's steadily regaining her weight.

sooooo. i have no real advice!!!!

my surgeon told me that the DS is a specialty operation that is done by only a few surgeons. the weight loss doesn't seem to be as durable [although i think that this really depends on the person and their habits and commitment], and there's a higher rate of complications [and that could depend on the surgeon's experience].

DO YOUR HOMEWORK. DO YOUR RESEARCH!!!! and please post whatever you find here. we ALL need all the information we can get...

[Young Grasshopper]

Thanks for the support. Have the meeting with the doc tomorrow...been doing research today. It's 1:45 Am now....hope I'm awake to ask the questions. I've posted on AMOS website...got 57 hits and caused a huge debate. I just wish this wasn't so absolute, you know? Like if it went wrong I could go back to what I had or was internally. Know what I mean? And I really hate the idea of going through all of this and eating my way out of it...not cool. Fill like a real dope then.

Jiffy, is your DS friend that lives near you out eating the surg?

Dawnajoy would LOVE your imput!

Deb

[jiffypop]

yes deb. my friend is indeed out-eating the surgery. and it's really sad.

and you're right - this IS an absolute - no-going-back kind of thing. that's why we have to be SURE that we've done all we can to diet... and that we make great progress in getting past the compulsive eating.

this IS forever, and we can manage it so that we are healthy or we can ignore what we've done and try to live the way we did before surgery.

some folks just never understand this...

what happened at the docs
???

[Dawnajoy]

I am so glad I signed on today!

I had the duodenal switch and have a lot of information about this surgery. I did a huge amount of research before having my WLS and truthfully would not have had the RNY had it been my only choice. That said, after having lost my weight, my opinion has changed. The DS absolutely would be my first choice and I would have fought long and hard for it, but if the RNY was the only procedure my insurance would cover and I could not come up with the cash for the DS, I would have it.

Jif, I would love to be in contact with your friend. I have been in the DS "community" for over five years, and have heard of a few people having less than optimal weight loss (less than 10 people in that five year period that I am aware of), but not one of a person having a significant regain. A regain of up to 10% is not unexpected after a few years but more than that is surprising.

The main reasons I chose the DS over the RNY is the statistics about regain. My research showed that RNY had a much higher incidence of regain than the DS in the long run.

The second issue for me was dumping. The DS rarely, if ever, causes dumping and having watched my mother suffer from dumping syndrome after an early WLS, this was NOT something I considered acceptable "for me". I know others who have had the RNY consider it a built in behavior mod.

The third issue in favor of the DS, for me, was the fact that after about a year you settle into eating a "small normal" meal. I wanted a more "normal" eating pattern after time. No pouch rules. Protein first, and vitamin supplementation are key.

The trade off with DS versus RNY is that it is a more malabsorptive surgery. You absolutely MUST be committed to vitamin supplementation for life. It is non negotiable. This will make or break your long term health with the DS. I have seen a few people get into trouble by not supplementing regularly and it is not pretty.

The DS has significant "bowel issues" for many people. Many trips to the potty. There are false warnings going around the 'net about foul smell of the body (not true). I have heard repeatedly that DS causes "lower GI tract" issues (i.e. potty issues) and RNY causes "upper GI tract" issues (throwing up). I have personally had no issues in this regard, but I am unusual in that.

I know several people who had the DS and had horrendous surgical complications (on the boards). I know many RNY people who have regained significant amounts of weight (personal friends). I know people who have had both surgeries who strugged emotionally with respect to eating changes.

There are no stoma strictures or ulcerations with the DS. We have no stoma, we have no pouch. The stomach is transected but it's functioning kept intact including the pylorus, thus no dumping.

The DS is a more complicated surgery. It is only done by a few surgeons. There are longer RNY stats available than DS. There is a lot of misinformation out there, and feelings run strongly both toward and against each surgery. My advice is to do your own research. Read the studies, decide for yourself. The year I spent researching and being active on the DS and RNY boards was the best thing I did for myself. I had no doubts about my choice and have never looked back.

Do your own research. Positives and negatives with each. Do what is best with you, given your weight, your health and your emotional makeup.

Take care,

Dawna

[Chickadee]

Great post Dawna! As I was reading, it hit me that you chose the DS for many of the same reasons I chose LapBand. I also didn't want the RNY, but would have eventually considered it if there was no way to be banded.

I'm certainly not trying to sell anyone on any surgery type - I just think it's very interesting how we all come to our conclusions. One of the main reasons I went with banding is because of regain. With the banding, you have control over regain because you can adjust the amount of saline in the band. Trust me, when your fill is at that sweet spot, it's very difficult to overeat. Of course, you could out eat the band by choosing the wrong foods ( not that I'd ever eat anything like that), but good restriction really makes you think twice. Even though my weight loss has been pretty slow lately, I've taken a lot of comfort in the fact that it is going down and I haven't regained anything.

I also chose the LapBand over RNY because of the dumping issue. I really didn't want to deal with that and I absolutely hate, hate, hate fake sugar. When I was in the choice making stage I had to be honest with myself and admit that I wanted to be able to have treats with sugar every so often.

I also wanted to be able to eat a small normal meal. To be honest, I can't always do that, because certain foods just don't go down well, but in theory it's a possibility. Usually though, I can eat whatever my family's eating.

I also considered the vitamin issue. I know me well enough to know that I'm terrible about taking vitamins. I usually do now, because I've been forcing myself, but if I don't there aren't the horrible consequences other surgery types will have because we don't have the malabsorbtion issue. The band has way fewer complications from surgery too, just because it's a much simpler operation. Of course, we also lose weight more slowly than either DS or RNY folks. It's all a trade off and what's best for a particular person.

Didn't mean to make this so long, but it amazed me how we each considered the same issues in making our decisions.

Chickadee

[Young Grasshopper]

Hi All,

Thanks for your input on this question. Still doing the research on it and thinking. I postponed my meeting with my surg. until tomorrow (a week) to do more research on the DS. DId it help much? Nope. lol. Wish there was an easy answer.

The thing that gets me is that there aren't a lot of docters that do it. I've lurked on several Yahoo groups for DS and a lot of them seem to go out of state or out of the country to get it done. I worry that if you have this type of procedure, and something goes wrong God forbid, that a reg doc in the ER won't know what to do. That my OB/GYN, PCP, whatever...won't be able to understand how certain things would effect the new DS system. Heck, I"m amazed at the amount of blank looks I got when asking about effects of RNY. (Yeah, I've been a real treat as a patient this last year).

Tonight I thought I'd go through my stuff one more time and then write up any more questions I might have for the doc. Part of me thinks, "Hey, forget the surg. you can lose the 160lbs on your own."...you don't need to do such a radical thing. The other part knows the statistics and better yet, knows me.

The DS has some appealing features. I like the idea of keeping a "normal" stomach and not having the dumping and vomiting problem. On the other hand, what's to stop you from eating junk agian?

I'm getting frustrated and depressed to be honest. The window is closing on my insurance, and getting this done, and I'm still not sure what I want. I know that I need to do something but I worry about this permanent change thing....

I'm sure I'll be a real treat for the doc tomorrow.

Hope everyone is doing well

Deb