Second Guessing

Okay, my RNY is scheduled for February 9.  I have been very comfortable with that choice, but the last couple of days I am wondering if I should go with the duodenal switch.  The reason I am considering the DS is because it is less malabsorptive and I wouldn't have to worry about vitamins, minerals, etc. etc.  I read that the DS is malabsoprtive for fat and carbs only, so that it has a better long-term weight loss result.  Also, you have wider food choices than with the RNY.

Questions:  Is it too late to switch my surgery?  Is it normal to second guess?  Anybody have opinions on the advantage of DS over RNY?

Thanks!

Linda -

Yes, it's normal to second guess.  If you were calm and worry-free... we'd be worried.  This is a huge decision.  So careful considertion is essential.

DS is NOT less malabsorptive.  In fact, it's MORE malabsorptive and lots more intestine is bypassed.  And you'll be required to take lots more vitamins.  And although more fat is malabsorbed... that's not the case with carbs - carbs are considered absorbed at 100%. 

Do some more research.

Pam

Thanks, Pam.  It just goes to show you, it all depends on "where" you get your info.  I first decided on the RNY because everything I read listed it as the "gold standard" of WLS with the best long-range results.  I want to get this right!  Thanks again.

Linda -

Yes, RNY is considered the Gold Standard of WLS.  It's the one most commonly done and the one we know most about because it's been studied the most.  However, there ARE instances where the DS might be better for people.  Just like some people would do better with the LapBand or Sleeve.  Yes, DS does have good long term results for sustained weight loss -- but you also have to weigh that pro against the cons that come with that particular surgery (more malabsorption, more vitamins, need for more fat in your diet, etc.).  Just like you'd need to weigh pros and cons of each of the 3 other surgeries...

And no -- it's not too late to change your mind.  If you're not 100% confident in  your decision on surgery type, there is no harm in postponing your surgery date until you are absolutely sure you're making the right choice.  This is a life time decision and not one you can easily "change your mind" about.  So whichever surgery you choose you have to have peace of mind that its right for YOU and then have the faith in your decision to work with whatever happens afterward without regrets or second guessing.

A lot of the decision of which type of surgery -- and the success/failure that follows -- depens on the personality, habits and needs of the individual person.   For instance I knew that the Band was not right for me because I had no problem restricting the amount of food I ate - I did 1200 calories for 2+ years before my surgery and still couldn't lose weight.  I didn't need restriction alone, I needed the physical cut of the RNY to put a halt to the insulin resistance that was causing my weight gain and inability to lose weight.   So it's a matter of researching the details of each surgery and matching those details to what YOUR body needs specifically for your success.

A good resource for understanding the different surgeries is this website -- it is a wiki assembled by WLS patients who have done the research on their own individual surgeries.   http://www.wlswiki.com/index.php?title=Main_Page  Click the link for "WLS Comparison" and you'll see a good chart that gives an overview of each surgery.

Dang... rambling again.  Sorry.

Believe me, you are NOT rambling at all, and I truly appreciate your sharing this information. 

I too have been on many restrictive diets in the past - I am a lifetime Weigh****cher member twice over.  No problems limiting portions.  But I also have metabolic resistance, and since undergoing a hysterectomy and now nearing the big 5-0, it is getting darn near impossible to keep the weight off.  Every year I add another couple of pounds, until now I am at this point where WLS seems like the only option for living a long, healthy and active life.

You have calmed my jittery nerves.  Thanks so so so so much!

i think to second guess is more normal then you know.  I know it was for me, not with the DS but with others, but i did my research and just stuck to the one which fit my needs.  It's easy to get caught up and second guess. 

Good luck.

I also chose RNY because of insulin resistance.  My diabetes was getting out of control, my last A1-c before surgery was 7.6, way to high.  We were considering adding another type of diabetes drug and doubling my blood pressure meds.  My gerd was killing me, and I was on 2 meds for that. 

I considered the mini gastric bypass (allot of controversy about that one), lap band (I needed the fear of dumping and size control) and my insurance did not cover DS, with all of that I decided on RNY for me. 

The day I left the hospital I was only taking Previcid, as a preventative for ulcers, not because of gerd.  That's it, no diabetes, hbp or gerd meds....none!  At my 6 month labs my A1-c was 5.2!!!!!  Un-fricken believable.  I was thrilled beyond belief. 

Last month my 2 year labs were stellar again.  My A1-c was 5.3 my chol. was 158 my hdl was high and my ldl was low and my triglycerides were 151 (at one time they were in the 500's....yikes).

I will be the first to admit I allow myself a piece of chocolate or two most days (mini size), I eat whatever I want, I just make sure protein is the main course.....the only thing I cannot do is pig out.  I can handle a few bites of pie, cake.....I do not feel cheated in any way. 

As Pam said if you were not questioning yourself about surgery, we'd be worried.

Good luck with any decision you make,

Edie

You have been completely misinformed.  I would speak to your PCP/surgeon as soon as possible to discuss both procedures and make a decision.

The surgeon had recommended the RNY but did mention the duodenal switch.  Later I read (on-llne,of course!)  about the supposed advantages of the duodenal switch and this article specifically said that with the DS there was no or little fat and carb absorption, which made for better long-term success. 

Since my surgeon, my primary doctor and I all discussed and agreed on the RNY, I am confident with that, but still  . . ... for  minute . . . .  I was having second thoughts.

Thanks again to everyone for your help!

Check out the DS forum board under upcoming surgery dates.  There is a post that explains some of the differences.  I found it very informative.  My research was based on co-workers and friends.  I work for a large insurance company where WLS is covered.  I tease people that I'm going to be the only fat person left in the company. :)  I have based my choice on their success and failures. 

Here is the break down:

16 RNY- only one at goal, one just joined WW because she put back on 30 pounds,  One just returned to work because he had problems with an ulcer.  4 not quite at goal but are happy with their results. 2 looking into a revision

7 DS- 3 at goal, 2 below goal, 2 still losing (one eats a pound of bacon a day and they took her off her cholesterol medicine.

2 lap band- no one anywhere near goal and one considering a revison

2 VSG- Both loves their sleeves and are still losing.

This information is my personal research.  You have to do what is best for you.  Dr. Kemmeter has a facebook page.  He agrees there is no one size fits all.  I won't mind taking 10 vitamins a day.  I take 6 a day anyway between cholesterol meds, insulin meds, BC pills, etc.

Best of luck on your journey!!!