AMEN !

Wow, so much anger in this room... Ok, first and foremost, the modern duodenal switch STILL involves creating a smaller pouch, just not nearly as small as in an RNY. Second, most people who's surgeons opt for an RNY bypass do so because it changes the relationship between the pancrease and small intestine. This results, but not immediately, in a lower demand on the pancrease for insulin (which in most people with diabetes, PCOS or pre-diabetic conditions) and thereby lowers the insulin out put and can eliminate insulin resistance. Pre-surgery/pre-metformin, my insulin count was 13.8. I am 4.5 years post-RNY and my insulin count was 3.2 about 6 weeks ago. My A1C was 5.8 %. This evidence refutes the claim that the pancrease is inherently dumoing insulin unprevoked. This is just my body that I can prove this on. But I know I must follow these rules for the rest of my life if I want my "tool" to keep working for me. I have other health problems (lupus) that have arisen after having surgery, that were NOT caused by the surgery. I can't possibly imagine dealing with lupus and PCOS at 330 lbs.

WHERE HAVE YOU BEEN SERENDIPITY????? glad to see you back and doing so very very well.

and, as always - a wonderful response. it's been a little weird around here - but i think things are getting back to normal.

what have you been up to???

The current DS does not involve creating a pouch - the stomach part of the procedure is a vertical sleeve gastrectomy where about 80% of the stomach is removed completely, and the pylorus at the bottom of the stomach remains fully intact and in use (as opposed to with the RNY pouch where the pylorus is bypassed and left at the bottom of the blind remnant stomach).

I'm not sure if the rest of your post was intended to be information for RNY in general, or in contrast to the DS (since there was no spearation after the DS tatement), but the DS also inflicts a metabolic change due to the intestinal reconfiguration and, in fact, has higher resolution rates for insulin resistance, type 2 diabetes, etc., than the RNY (not saying the RNY can't or doesn't work because it very clearly does for many people, but studies show an even higher rate of success with the DS).

Before my DS, my most recent A1Cs were 8.1 and 7.9 with a fasting glucose in the 180s on morning of surgery, and that was with being maxed out on metformin and also taking Januvia. At my 3-month post-op labs, my A1C was 5.4 and fasting glucose 90, after having ditched the Januvia on surgery day and cut my metformin to less than half. Now, I am on 500mg metformin until my next labs at 6 months post-op, at which time, if my levels are still this good, I can kiss all my meds good bye!

Diabetes (and anything involving insulin resistance that can lead to diabetes) is just plain evil - I am so thankful we have these surgical options that are far more effective than diet and exercise alone.

I agree with Jill! Having such health problems that are so difficult to control really is torture. My apologies for my misinformation about the DS. I got my info from this link, I believe it was up to date as of 2006. http://www.duodenalswitch.com/procedure/procedure.html Please let me where I can find more accurate technical info, I would really appreciate it.

Hi Jiff!!! How are you?? Sorry I ditched y'all for so long. The past few years have been kind of harsh. I found out last week I have severe lupus, left my husband about 2.5 years ago, had to stop working out a year ago because my resting heart rate was 150-180 and I COULDN"T STOP LOSING WEIGHT, got laid off, went back to work, finally went on state disability because I was too exhausted to get out of bed, went on heart meds, gained 52 lbs, lost 7 very carefully and am officially on bedrest, lol. But I still have my sense of humor and my sense of compassion (I hope)! All in all, things are getting better. I finally am on the right treatment and I plan on going back to school this fall.

WOW Girl, sounds like a rough ride

School !!! very cool, congratulations.

That link is correct - it says what I said:
"Unlike the unmodified BPD and RNY, which both employ a gastric “pouch” and bypass the pyloric valve, the DS procedure keeps the pyloric valve intact. This eliminates the possibility of dumping syndrome, marginal ulcers, stoma closures and blockages, all of which can occur after other gastric bypass procedures."

Partial gastrectomy, not a pouch.

I commend you on maintaining your senses of humor and compassion - I've had family members with lupus, and I know it can be very difficult to handle (there is conflicting info on whether or not it may be hereditary, so I am always on the lookout for certain signs and symptoms myself). It sounds like you're in a pretty good place right now, despite the roller coaster it sounds like you've been on for the past couple of years!

good heavens, OS!!!!!!!!! what a nightmare! and it took them THIS LONG to diagnose lupus? they'll get it under control, right? and you're with a specialist, right???? there are some great docs in san diego.

but now that you're back, you're gonna hang out with us more, right??? i'm sounding like a nag, right? LOL!!!!!!!!!

Thanks Jill! My younger sister has a relly mild form of systemic lupus. She had all the blood tests come back positive before she was symptomatic. I don't know how old you are, but if you suddenly find yourself questioning if you're going through early menopause because of hot flashes and night sweats, then I would start asking questions, lol. My mom has psoriasis and her twin sister has sarcoidosis. Lupus in and of itself isn't considered hereditary, but the odds of getting it are a bit higher if an immediate family member who also has it. Something about being gentically pre-disposed to auto-immune disease, if I remember correctly. I have all the physical symptoms and the only positive test I had was an anti-phospholipid antibody test. It isn't uncommon for a definitive diagnosis to take as long as 10 or 15 years. 20% of people with auto-immune diseases never test positive, so they end up with more severe problems because of a lack of treatment. But I do ok. I'm having some of my worst days yet but I know that I need to be around other people as much as I can. Someone once told me that spending too much time in your own head is like being in a bad neighborhood. But enough of that! This isn't Oprah! lol I guess the pictures on the website for DS confused me, hehehe. My weight has been pretty stable and slowly losing again but my sleep schedule is soooooo upside down. I run a fever at night and it's impossible to sleep when I do, so I end up going to sleep if/when it breaks. Yes, I have a FABULOUS rheumatologist! He's written or contributed to more than 20 books and numerous other publications for lupus. We definitely have world-class medical care here. I couldn't have been in a better place. I am hopeful that once I get things under control, I will be able to have a consistent schedule and work-out plans again. My biggest fear is that this bone-crushing, breath-stealing fatigue will never go away. I went down this path of surgical weightloss to improve my health and quality of life. I am holding out to see normal energy levels again.
Don't worry, Jiff! You're not nagging, lol. This is where I need to be. I think... lol

seriously - if there's anything i can do to help, just holler. you KNOW i have certain information resources available -

sounds like your family would make GREAT subjects for a study of the heritability of autoimmune diseases.

I will definitely keep that in mind, Jiff. Thank you!! I am convinced the the auto-immune problems are related to my grandmother taking a drug call DES that used to be prescribed for miscarriage prevention ages ago. It was confirmed that female children born to women who took this drug during that pregnancy were born with reproductive disorders. For years, no one conducted further studies except Canada who found that 3rd generation exposure (original grandmother's grandkids) boys had an astronomically high incidence of auto-immune disorders and that 3rd generation girls had higher occurances of reproductive disorders.