WLS'rs- Why do you do this to yourselves?

I just wanted to say...this was a very good post.

I am considering DS, because of the research I have done. My first choice was RNY, but I am glad the Dr. I have chosen does all 3 procedures.

I will meet with him, and his crew to see what there thoughts are.


I really enjoyed reading this post!

I love my RNY and personally am glad that you are satisfied with your choice as well.  I think it would be kind of you however, not to make others who choose differently than you to feel as though they somehow made a mistake.  What the WLS community needs is individuals who support all of the choices that are available, not people who attempt to divide this community.  I hope that I am mistaken about the tone of your post, and if I am then I will readily apologize.  BUT I for one am PERFECTLY content with the choice that I made, and it has been teaching me a great deal about learning to eat healthier.
Becca 

Great post Rock!

As one who has had both RNY and DS, let me add my perspective. You nailed it, I was successful in keeping the weight off for 15 years, but it wasn't because of the RNY, it was because I was on a DIET and I EXERCISED every damn day! When I couldn't exercise, the weight came back and I never could get it off again. You can read all about it on my profile if you want the details; it's public.

I was in RNY hell for 28 years, so I know what I'm talking about. Sure, some can keep the weight off for awhile; but for how long? I've yet to read of anyone on OH that did it for 15 years, let alone 28 or more and that is what the real problem with RNY is. RNY is not a long term solution to Obesity, it's a start, it helps you get the weight off, but that's it and after that, it sucks rocks with all the damn pouch rules and problems.  

It's really quite simple; long term, RNY sucks, DS rocks.

Kerry

I am so sorry you were so unhappy with the RNY and it cause so much of a hassle for you, causing you to have to watch what you eat and exercise every damn day.  I know that's a hassle.  Many people tho have much success and are very happy with their decision . 

Now, that you have had DS, let me understand...you are less restricted, in other words you can eat anything you want, and you are not forced to exercise for fear you will put the weight back on...It sounds to me that maybe that was why you needed weight loss surgery to start with.

Like you said, in another post...your are new the DS and YOU REALLY DON'T KNOW THE LONG TERM EFFECTS FOR YOU. 

Not only will you not have to be as aware of what you are putting in your mouth or forced to exercise, but now you are also teetering on the malnutrition fence.

Malnutrition can happen just as easily with the RNY as with the DS since the entire duodenum is bypassed in the RNY, whereas the DS leaves a small portion of duodenum in the alimentary limb. Both have malabsorption, just not of all the same nutrients. The only supplements I take that most RNYers do not are vits A and D (though more people probably should be taking D, but that's another story!).

You would be wise to go read my profile and see why I couldn't exercise every day. I got Hep C from a blood transfusion I had to have because I almost bled to death when some of the staples tore a hole in my stomach. Taking Interferon injections every other day for year pretty much saps any energy you have; you feel like you're coming down with a really bad flu every other day and there's no way I could exercise. It's really hard to just drag yourself out of bed and go to work every day.

But that really isn't the point; the point is that RNY is no help what so ever after the first year or so and after that, it's a giant PIA having to live with the damn pouch. And that even if you want to exercise every day to keep the weight off, you may not be able to do that; crap happens. It's also a fact that if you have joint or pain problems, you're screwed with RNY because you can't take NSAIDs.

You understand a little, but very little about what and why a DSers can eat. While it's true we don't have dumping or food getting stuck or foamies, we also can't just eat anything we please and keep the weight off. We absorb 20% of the fat we eat, 40% of the protein, 60% of the complex carbs and 100% of the simple carbs. So for a DSer to be successful we need to eat protein and fats first just to get enough and then we can add some complex carbs and if we have room a few simple carbs. The point is that we can and do eat like normal people eat and we don't have to exercise to lose or to maintain our weight. It's a wonderful freedom we enjoy and one that anyone looking into WLS should understand before they decide which WLS to get.

I have a very good idea what the long term effects of the DS are; there are a number of 15 year peer reviewed studies on the subject. And while it is surely true that we have to be compliant with our supplements it's also true that RNYers must also be compliant in taking the supplements they need to be healthy. The supplements are different for RNY & DS, but equally important. Since I get blood drawn and labs done every 6 months, I will know, long before I have any malnutrition issues that I'm trending down on any important nutrient. So far, my labs are perfect, but I'll be getting blood drawn later this month so I'll know more then about how I'm doing.

As far as exercising goes, I like to exercise, I water ski, snow ski, play tennis & golf and I work out with a personal trainer three times a week.  That's not the point, the point is that we shouldn't have to exercise like a maniac or diet just to keep our weight under control.

I also know the long term effect of RNY, both from the studies and from 28 years of experience. The long and short of it is that compared to the DS, RNY just plain sucks, there is nothing it's better for, there's nothing that it's even as good as, nothing.

If someone wants RNY, that's OK by me, it's your choice, my only concern is that people make an informed decision and one can't make an informed decision from ignorance or misinformation. And that is what I see mostly here, total ignorance and misinformation. Most of it spewed by money grubbing surgeons who are to damn lazy and self centered to get current on the facts and relay those facts to their patients. And being way to greedy to tell a patient about a better WLS they do not have the skills to perform.

Kerry

Great post Rockne;

If it weren't for the DS'ers being the "in your face types", people like me would never be made aware that there was another surgery out there besides the ever popular RNY, and the Lapband....  I was almost finished with the RNY program at a very popular bariatric center when I started really reading about the DS-because of posts like Rockne's. 

Yes-the RNY has its place. However the DS does as well.  And when so many surgeons-who are "selling a product"-and are not capable of performing the DS-are trash-talking the DS because they don't want to have to spend their precious time learning a new surgery -then we need people to scream it from the rafters that yes-we do have other choices.  How can we make an educated choice of any kind if we aren't aware of what our choices are??

Rockne..........your post reminds me of the kid who stood up at the parade and yelled "THE EMPORER HAS NO CLOTHES" and as one who's always had a lot of respect for that kid, I applaud your post.

Some answers perhaps to your question WHY in the form of my own questions come to mind:

To Jerry re: revision from RNY to DS...............so those of us who have "opted" for the RNY and successfully reach goal (for me a BMI of 20 on my small frame seems appropriate) if we find we are having trouble maintaining once at goal, do we have to become MO again in order to be a DS candidate? or can things be "nipped in the bud" so to speak.

Back to Rockne............My conclusion at 3 months out concurrs w/your assertion that $$$$ and technical expertise are playing a big role in suppressing the DS success story. I also think there's that little factor referred to as aversion to Change rearing its ugly head, maybe subliminally even in surgeons who are performing WLS for all the right reasons but have "perfected" the RNY technique and take great satisfaction in seeing patients success, which is enough to keep them from going down a road less travelled and thru the trouble of more training because human nature being what it is, I suspect, conjecture, opine (in the absence of objection from a WLS surgeon) they rarely see us after regain. But there is also this that nags on me as one having gone into consultation w/a BMI of barely 40: What's the down side???

Every procedure has one or two right? I hear you about needing to take supplements, but it isn't taking the supplements that would make me think twice b4 opting for a DS........it's the REASON supplements seem to become so much more important to the DS patient than the RNY patient that give one pause. I almost hate to say it aloud,lest  the political machine latch es onto it as argument for RNY..........at the same time, i'm not finding the answer and maybe some DS people could help me out here.  We all know one of the biggest risks w/any WLS procedures is malnourishment (which is odd considering many of us are malnourished AND overweight but that's another issue) and the DS malabsorbs more than the RNY so when I researched my options as best I could before making a decision, it made sense to me that the DS is "generally reserved" for the SMO and being as to how that was the line of reasoning presented by most "authorities" and little else is available to laypeople, I let it go at that.

So my long winded overly analytical question here is do we know the long term results of dramatic malabsorbtion in as much as suplements can only provide so much in the way of nutrition? Also does do the pros of the DS outweigh the cons of the RNY in having the patient assume the added risk of longer op time? What is frustratingly muddy in all of this is the question of whether information re wls is being dissemintated in the patients best interest? the surgeon's practice/medical field? or the insurance companies?

My own experience is that the insurance companies, in bed w/the medical practicioners, have the corner on the propaganda market..............but that doesn't neccessarily mean their recommendation isn't sometimes also best for the patient? How do we sort out the difference?

As far as self blame goes, I don't need to tell you it is the direct result of decades of misinformation and bias in addition to the need to feel we are in control of our own bodies that so successfully perpetuates the "personal responsibility" argument letting science off the hook.

I think this was also a great post from someone on the other side.

I loved your post and couldn't agree with the twisted web of government, insurance and medical professionals.

I can offer that the DS has been around for 20+ years and there is no additional trending to malnutrition in those who watch their nutritional levels.  The key is to pay attention and know that no matter how good you feel, that you still need to watch your nutritional health.  We tweak along the way with supplementation.  There is no magical combination that works on everyone.  The RNY's are very similar in that respect, and thanks to people like Andrea U, they are getting word out that Flintstones and Tums are not the proper nutrition that RNY's need either.  I'd also like to add that our larger stomach capacity allows us to eat more nutritious foods as well, so many of us don't need protein supplements at all to get in our required 100g of protein.