reopst from main board... Pre-ops research DS before you choose a surgery
Diana Cox posted this today, and it made me think of a few newbies on here that are still on the fence about which procedure to have. She has some good points to consider.
"Nothing makes me more upset than to hear about someone who has some other surgery who is now struggling and wishing they had the DS, especially when they say that they had never heard of it, or had only heard lies and exaggerations about how "big" or dangerous a surgery it is, compared to the others.
The DS is, on average, the most effective of ALL of the weight loss surgeries, and the easiest to live with. It is the most malabsorptive, but allows the most normal eating of any of the surgeries (in fact, better than normal, in most DSers' opinions), and the best chance of losing the most weight and the best chance of KEEPING that weight off long-term. Keeping healthy means eating a high protein, high fat diet (which DOESN'T suck!), taking supplements (generally a couple of handfuls a day) and doing labwork and adjusting if necessary.
It has no greater surgical risk in competent hands. There is NO reason to reserve it for the super morbidly obese, because it can be tailored to the patient, by adjusting the lengths of the alimentary tract and common channels, as well as the size of the gastric sleeve. There is no dumping, no risk of marginal ulcers -- we keep a normally functioning stomach, with our pyloric valve, that is simply made smaller along its lengtth (the sleeve gastrectomy) -- over time, it stretches out to be about 2/3 the size it was before surgery, so you can eat a small normal meal -- then the intestinal bypass helps keep the weight off.
It is, however, the most technically difficult surgery to perform, because the surgeon must be quite skilled in suturing duodenal tissue, which is difficult to work with, and so it can't be learned in a weekend seminar. DS surgeons typically must proctor with an experienced DS surgeon, and most general or bariatric surgeons don't care to take that kind of time to learn a new procedure -- especially when some of the insurance companies don't make it easy to get authorization for it. Nevermind that it might be better for their patients -- follow the money!
The worst thing about the misinformation that is promulgated about the DS is that much of it comes from surgeons who are not qualified to perform it. They cite outdated statistics, including statistics that confound the results of the DS with those of the BPD (an outmoded predecessor surgery), and that don't take into account that earlier studies included a disproportionate number of the heaviest and thus sickest patients. They also say that DSers have uncontrollable gas and diarrhea. These are unconscionable lies. I guess many bariatric surgeons feel the RNY, VSG or Lapband is "good enough" for most of you.
The DS is in most cases (>98%) a CURE for type 2 diabetes. Even for those DSers *****gain a little weight after hitting their low, the diabetes almost NEVER comes back. This is not true for RNY, VSG and Lapband -- and those procedures have a much higher risk of regain, and in particular substantial regain.
The DS also cures hypercholesterolemia, hypertension and sleep apnea in the vast vast majority of cases, and again, even if there some regain, these co-morbidities almost never come back.
Do yourself a favor -- before you hop up onto the operating table, make sure you understand the TRUTH about the DS. Come over and read our posts on the DS Forum and learn the FACTS before you settle for what your local, in-network surgeon is willing and able to give you. "
"Nothing makes me more upset than to hear about someone who has some other surgery who is now struggling and wishing they had the DS, especially when they say that they had never heard of it, or had only heard lies and exaggerations about how "big" or dangerous a surgery it is, compared to the others.
The DS is, on average, the most effective of ALL of the weight loss surgeries, and the easiest to live with. It is the most malabsorptive, but allows the most normal eating of any of the surgeries (in fact, better than normal, in most DSers' opinions), and the best chance of losing the most weight and the best chance of KEEPING that weight off long-term. Keeping healthy means eating a high protein, high fat diet (which DOESN'T suck!), taking supplements (generally a couple of handfuls a day) and doing labwork and adjusting if necessary.
It has no greater surgical risk in competent hands. There is NO reason to reserve it for the super morbidly obese, because it can be tailored to the patient, by adjusting the lengths of the alimentary tract and common channels, as well as the size of the gastric sleeve. There is no dumping, no risk of marginal ulcers -- we keep a normally functioning stomach, with our pyloric valve, that is simply made smaller along its lengtth (the sleeve gastrectomy) -- over time, it stretches out to be about 2/3 the size it was before surgery, so you can eat a small normal meal -- then the intestinal bypass helps keep the weight off.
It is, however, the most technically difficult surgery to perform, because the surgeon must be quite skilled in suturing duodenal tissue, which is difficult to work with, and so it can't be learned in a weekend seminar. DS surgeons typically must proctor with an experienced DS surgeon, and most general or bariatric surgeons don't care to take that kind of time to learn a new procedure -- especially when some of the insurance companies don't make it easy to get authorization for it. Nevermind that it might be better for their patients -- follow the money!
The worst thing about the misinformation that is promulgated about the DS is that much of it comes from surgeons who are not qualified to perform it. They cite outdated statistics, including statistics that confound the results of the DS with those of the BPD (an outmoded predecessor surgery), and that don't take into account that earlier studies included a disproportionate number of the heaviest and thus sickest patients. They also say that DSers have uncontrollable gas and diarrhea. These are unconscionable lies. I guess many bariatric surgeons feel the RNY, VSG or Lapband is "good enough" for most of you.
The DS is in most cases (>98%) a CURE for type 2 diabetes. Even for those DSers *****gain a little weight after hitting their low, the diabetes almost NEVER comes back. This is not true for RNY, VSG and Lapband -- and those procedures have a much higher risk of regain, and in particular substantial regain.
The DS also cures hypercholesterolemia, hypertension and sleep apnea in the vast vast majority of cases, and again, even if there some regain, these co-morbidities almost never come back.
Do yourself a favor -- before you hop up onto the operating table, make sure you understand the TRUTH about the DS. Come over and read our posts on the DS Forum and learn the FACTS before you settle for what your local, in-network surgeon is willing and able to give you. "
DSers: PAY IT FORWARD! High wt/current/post-recon goal: 293/169/160
My posts disseminating information about the DS are intended for pre-ops and potential revision patients only. If something I write offends you, in particular, if you are a post-op from a non-DS WLS that I am comparing unfavorably to the DS, remember your reaction is your choice. Use the block button if my posts upset you. 6+years out, I eat 3000+ calories/day, absorb less than half of that (high protein, high fat) and I'm still losing weight very slowly. You can't beat that with a stick! Come learn more on the DS Forum Message Board.
It is my firm belief that this board does not become a 'surgery wars' board. Each person has their right to determine which surgery is best for them, it is called free will. I also believe that the weight of the person should determine what is the best surgery for that person. To me, a lapband surgery would not be the best surgery for a person that is 300+ lb person or a person that had type 2 diabetes, and like wise a DS surgery would not be the right surgery for a person that is only 100+/- overweight. But these are only my opinions, and I am not going to 'shove' it down someone's throat that they should have the RNY only because I had it.
When I was having my surgery (approx 4.5 years ago), the main surgery being performed was the RNY, with some lapbanders, and a few others thrown in. I really do not recall if DS surgery was even being performed in the State of Georgia, and not that I was wanting that surgery, but I was not willing to travel out of state or out of country to have my surgery. As it turned out, I did have a complication (partially blocked bowel obstruction at 10 months post-op) and I was so glad that my surgeon was right here to fix the problem. As it turned out, the obstruction was scar tissue, and can occur in any surgery. Thank goodness I knew that my surgeon was right here in the State of Georgia.
Please cease this type of discussion on this board. It is up to each individual person and their surgeon of choice to decide which surgery is best for them. End of Statement.
When I was having my surgery (approx 4.5 years ago), the main surgery being performed was the RNY, with some lapbanders, and a few others thrown in. I really do not recall if DS surgery was even being performed in the State of Georgia, and not that I was wanting that surgery, but I was not willing to travel out of state or out of country to have my surgery. As it turned out, I did have a complication (partially blocked bowel obstruction at 10 months post-op) and I was so glad that my surgeon was right here to fix the problem. As it turned out, the obstruction was scar tissue, and can occur in any surgery. Thank goodness I knew that my surgeon was right here in the State of Georgia.
Please cease this type of discussion on this board. It is up to each individual person and their surgeon of choice to decide which surgery is best for them. End of Statement.
It is not a surgery war post. It is just a repost which I thought had some relevant info for people to consider.
Diana is right most wls surgeons don't even mention DS as an option to their patients because they don't do it.
I just think it's important for people to know there is a 3rd choice out there.
Also DS is a viable option for lightweights. Your common channel and sleeve size can be customized for your height and weight.
I think a wise pre-op should educate themselves on ALL the options and weigh the benefits, side effects, and risks before they choose.
Diana is right most wls surgeons don't even mention DS as an option to their patients because they don't do it.
I just think it's important for people to know there is a 3rd choice out there.
Also DS is a viable option for lightweights. Your common channel and sleeve size can be customized for your height and weight.
I think a wise pre-op should educate themselves on ALL the options and weigh the benefits, side effects, and risks before they choose.
I think it is good to "nudge" folks into checking out all the options. LaShelle's post is accurate to the point that most Bariatric surgeous speak dispargingly of the "DS" and don't do the DS.
I guess being a sleever, I feel as if docs very often don't (or did not) discuss THIS option with patients and just go A or B - lapband or RNY. Most of this is simply b/c they were not educated on the sleeve, or didn't perform the sleeve. This of course is changing!
There is no shame in telling folks to educate themselves on ALL options...and lets face facts...the pharmeceutical makers of the Lab Band are making DARN SURE you know about their product...you just have to dig harder to find information on the lesser known surgeries.
And, as the docs learn more, the surgeries are ALL getting better and more fine tuned, so that the benefits outweigh the risks for those considered lightweights (or not SMO as LaShell states...)
I guess being a sleever, I feel as if docs very often don't (or did not) discuss THIS option with patients and just go A or B - lapband or RNY. Most of this is simply b/c they were not educated on the sleeve, or didn't perform the sleeve. This of course is changing!
There is no shame in telling folks to educate themselves on ALL options...and lets face facts...the pharmeceutical makers of the Lab Band are making DARN SURE you know about their product...you just have to dig harder to find information on the lesser known surgeries.
And, as the docs learn more, the surgeries are ALL getting better and more fine tuned, so that the benefits outweigh the risks for those considered lightweights (or not SMO as LaShell states...)
HW 366 (2004) * HW Pre-OP 271 (VSG) * CW 157 * GW 145
VSG - Dr. Paul Macik (Atlanta, GA) - 7/09
Post MWL Plastics with Dr. Peter Fisher (San Antonio, TX) 12/13
You're right Melanie. The sleeve is another one of those mystery surgeries nobody ever talks about. I didn't even know you could get a DS staged and do the sleeve and have it converted to DS until I did some extensive research.
The sleeve actually has the least side effects and risks off them all and is pretty much maintenance free years down the road. I'm curious why more surgeons don't offer it. I think once there is more long term data on how much weight is kept off with the sleeve, more prople will consider it.
Other less publicised ones are the fobi pouch, vertical banded gastrectomy (sp)... There are lots of choices out there.
Good point about those dang lap band commercials. You see one on every other billboard. Why is it you never see the lady bouncing on a tramplline hurling because something is stuck in her pouch??? Or doubled over in pain because her port flipped? Wonder if those models ever slimed?
Wonder if there will ever be a DS commercial? Hmmm? NOT!!!
I guuess you have to look at the surgrons like this... they're likely only gonna try to sell you on what they do. They obvioyusly are fans of the ones they do, or they wouldn't choose that as their specialty.
You wouldn't go to a Ford Dealer and expect them to pitch you on the benefits of owning a Honda. same difference with these surgeries. It doesn't mean the Ford of Honda is the only way to go, you just have to check out the features of both and decide which one you want.
A good way to get an unbiased professional viewpoint is to go to a seminar and a support group meeting with a surgeon that does all 4 major surgeries, rny, band, DS, and sleeve. I believe Dr. Smith is the only one in GA that does all 4. That way you are more likely to get info on all 4.
The sleeve actually has the least side effects and risks off them all and is pretty much maintenance free years down the road. I'm curious why more surgeons don't offer it. I think once there is more long term data on how much weight is kept off with the sleeve, more prople will consider it.
Other less publicised ones are the fobi pouch, vertical banded gastrectomy (sp)... There are lots of choices out there.
Good point about those dang lap band commercials. You see one on every other billboard. Why is it you never see the lady bouncing on a tramplline hurling because something is stuck in her pouch??? Or doubled over in pain because her port flipped? Wonder if those models ever slimed?
Wonder if there will ever be a DS commercial? Hmmm? NOT!!!
I guuess you have to look at the surgrons like this... they're likely only gonna try to sell you on what they do. They obvioyusly are fans of the ones they do, or they wouldn't choose that as their specialty.
You wouldn't go to a Ford Dealer and expect them to pitch you on the benefits of owning a Honda. same difference with these surgeries. It doesn't mean the Ford of Honda is the only way to go, you just have to check out the features of both and decide which one you want.
A good way to get an unbiased professional viewpoint is to go to a seminar and a support group meeting with a surgeon that does all 4 major surgeries, rny, band, DS, and sleeve. I believe Dr. Smith is the only one in GA that does all 4. That way you are more likely to get info on all 4.
**** I AM AN OH SUPPORT GROUP LEADER ****
WHY I CHOSE DS: No dumping. Highest percentage of weight loss, Best long term results, Won't regain weight! Eat normal sized meals, 96% diabeties, 90% high blood pressure, 80% sleep apnea cured. I 
MY DS!
My doctor told me to stop having intimate dinners for four unless there were three other people. ~Orson Wells
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