newbie, confused about surgery choice.

My personal opinion is that the DS is a superior surgery - IF you can be totally compliant when it comes to aftercare.  This includes, but may not be limited to: LOTS of vitamins (around $100 a month for me), plenty of protein, plenty of water, regular bloodwork, periodic dexa scans, etc.

Some people cannot handle taking 30ish vitamins a day.  Some people start out with good intentions, and get to feeling so much better and looking so healthy, that they assume they must be healthy and fall off the supplement wagon.  This is forever, and it isn't optional.

All that said, I'm very glad that i have a normal, smaller but fully-functioning stomach with my pylorus intact.  I love rich, flavorful food (butter, bacon, full-fat everything).  I love 'normal' portions. I love that i'm not punishing myself for having gotten fat - no dumping, no foamies, no puking, no endless diet of gross food.  I'll take a handful of vitamins in trade.

If it were my choice to make again, i would wait for the DS if insurance didn't cover it, or i had to do the supervised diet longer.  I would travel for an experienced surgeon if I had to as well.  If it were the RNY or nothing.  I'd take nothing.

ETA:  I also had a family history of some things such as Diabetes.  My risk for those now is virtually non-existent.

 Where I teach, four of us have had WLS.   Two have had the RNY, two the DS.    RNY'ers are six years out, I'm five years, and my other DS'er is four years out.   The RNY'ers have both gained at LEAST 50% of their weight back.   Me and my DS buddy?  We're sitting at just about the same weight we did when we hit goal!    Several of my colleagues have asked why we've done so well, and the others haven't.

The primary reason I decided to have the DS (after planning to have RNY) was because of its long-term effectiveness and ability to eat a more normal diet.   It's worked just fine for me!

I've had both RNY and DS Vanessa and from my perspective there is just no comparison. RNY sucks, DS rocks! The RNY I had done was back in 1980 and was a little different than what's done these days, but the results are the same. You will lose the weight with RNY, but it's very very difficult to keep it off after a couple of years.

The reason for this is that RNY has only a little bit of malabsorption after those first two years. The DS has a lot of malabsorption, you only absorb about 20% of the fats you eat and 40% of the proteins and complex carbs. This means you can eat satisfying foods that have fat in them with out gaining weight, it's a very big deal for those of us who love food. 

I would have been considered a RNY success because I managed to keep the weight off for about 15 years, I did it by exercising every day and always being on a diet. I tried every diet that came along. Then I got sick and couldn't exercise for a year and the weight started coming back, I lost control and ended up weighing as much as I did before I had the RNY.

I got a revision from RNY to DS in Sept. of 2008 and it's been wonderful. No dumping, no getting sick if I eat a little ice cream or drink milk, no food sticking in my pouch and I lost the weigh and am keeping if off effortlessly. Here's my 1 year out post: 

www.obesityhelp.com/forums/DS/4024505/One-year-ago-today-who-could-have-known/action,replies/topic_id,4024505/page,1/

I would get the DS if I were you, a revision is not something you want to have to consider, it's a really rough and expensive way to get the right surgery. Get it right the first time.

Kerry

I'm a former RNY'er too and struggled for at least 14 years with weight gain and dieting and worsening diabetes and hypertension......all after my RNY. My DS is a blessing.

Here's what I tell people about how I chose the DS:

I was originally on track to have RNY back in 2002, but got derailed after preop testing revealed that I had pulmonary hypertension. It's a long story, but it's on my profile if you'd like to read about it.

Even though I was off the track for RNY, I continued to attend the program my then-surgeon required of all his patients. I'd paid for it, so I figured I could benefit from it anyhow :-).

I saw some disturbing trends there. This was a big group, as several surgeons sent patients to it. There was, of course, a cadre of very successful patients (all RNY). They finished their year of program and went on with their lives, and as far as anyone knew/knows, all is well.

There were a surprising number of people, though, who fought and fought and fought to comply with what was expected of them, and the weight didn't come off well. At every meeting, there was word of someone else in the hospital with this or that problem--usually an ulcer or a stricture.

I listened to stories of dumping episodes, of getting food stuck episodes, of the mental/emotional challenges of having to live on highly restricted diets.....and I thought, "There's not a chance in hell I could live with this." (I should add that I have a major vomiting phobia. I'll do just about anything to not vomit. Not a good thing in some cases.)

Well, time passed, I got fatter and sicker, and eventually (again, story in my profile), it came out that the pulmonary hypertension was caused by the fat on my torso squashing my heart and lungs. It went from, "You cannot have any surgery at all," to, "You must have surgery or die."

I came back here to OH, feeling desperate because the lap band wouldn't give me enough weight loss to have any real hope of curing what was ailing me, and the RNY seemed to me like foolish butchery for not enough good results.

Someone told me then about the duodenal switch, invited me over to the DS board, which at the time was pretty much brand new, and the rest was history.

What I like about the DS:

1. 98% cure rate for type II diabetes. This was a major biggie because I had very bad diabetes.
2. Normal stomach anatomy and function is maintained. The stomach is reduced in size, but the normal stomach outlet, the pyloric valve, remains intact and functioning. There is no "stoma" with the DS or the vertical sleeve gastrectomy (VSG).
3. The intestinal changes that are done in the DS "jump start" the body's metabolism. Mine was shot to hell from a lifetime of PCOS, dieting and other factors.
4. I'd already done many years of low fat, low carb, highly restrictive dieting and I knew I sucked at it. The DS gives an eating quality of life that I find easy to live with: eat a primarily animal protein based diet. I'm a happy carnivore :-). I had to learn to restrict my carb intake, but it was a lot easier to do when I could eat meat, cheese, fish, eggs, etc. with abandon, with little regard for fat content. (DS'ers only absorb about 20% of the fat they eat, so for most of us, fat is almost a "free" food.)

I felt so strongly about the superiority of the DS to any other procedure that I traveled and paid out of pocket to have it done, rather than have the RNY done fifteen minutes from home and covered by insurance. It's been four years, and so far, so good :-).

I would also second you visiting the revisions board. I am a band revision and I have to say I have a much better quality of life with the DS then I ever did with the band.

Try making a list of the pros and cons of each surgery as they relate to your situation. HTH

~Ann

 i canceled my RNY appointment about 2 weeks before my surgery was scheduled and started the process of finding a surgeon all over again. It was the best decision i have ever made. ;) I think you are going to agree.