WARNING TO PRE-OPS: Think twice, cut once -- or else!

Some of you people seem to have an adverse reaction to truth. You seem to not want facts and unbiased truth, you want to be diapered and coochie, coochied-cooed all day. Grow the **** up. This thread was never intended to bash any ones surgery. It was intended to inform PRE-OPS that they had better make an informed decision, weighing all WLS options before it's too late.

Some of you people seem to miss the whole point of Diana's (and other DSrs posts). The point being that this 'choice' you all speak so often of could very well be a matter of life and death that far outreaches the risks of simply being morbidly obese. YOU CAN DIE. Not only in the long run from being fat, but you can die:

1. In the OR (operating room) from not researching and picking a skilled surgeon
2. From not taking your proper supplementation
3. From having a less effective surgery that may never get you anywhere near a healthy weight. Or you may lose all the weight and then gain it all back. Either way, you'll end up right back where you started: Fat, with a ****load or comorbs (current or impending), and eternally miserable.

I don't know why there such a big hissy fit every time someone say that the DS is the best wls out there. It is, and scientific data, studies and facts can prove that. Independent thinking is what it's all about people. You cannot rely on a medical professional to solely have you best interests at heart. The medical community is a trillion dollar industry. You'd be a fool not think that medical team i.e. surgeon/nurse/nutritionist, are concerned with making money. Yes, yes, I'm sure they all have the mind of mother Teresa and a heart of gold.

OH can be a very supportive site indeed. I have learned so much since I became a member back in May. But I've got to tell you, when it comes to improving the quality of my life, I don't need people on an Internet forum to hold my hand and tell me that everything is going to be OK if it's not. And that's the one thing you gotta love about those DSrs. On any given day, no matter what the question, you're always sure to get FACT before and OPINION. And I don't know about you, but if I had to choose between fact or opinion, life or death, I'm choosing facts and life every. single. time.
 

Kristal, there  you go again saying Ds is the BEST possible wls. Pull your head out of your ass. You will have enough medical issues with malabsorbtion of much needed nutrients to waste time with you head stuck up your ass. 

I am Canadian. i don't pay for wls. Don't have to go hat in hand to an insurance company praying thy will approve me. In Canada you must meet specific criteria to qualify for wls.  My surgeons do not rely on the number of wls patients to earn a living. No monetary incentive to push one wls over the other 

While we are citing facts here lets hear your factual take on which wls surgery has the MOST vitamin and nutrient deficiencies associated with it. Unless you are vigilant to the point of obsession you can get into vitamin trouble. How's that for a bit of truth?

Rnyers have issues with absorption as well but nothing compared to DSers. We still have all of our intestine from which to absorb nutrients. The ones we miss are the vitamins which are absorbed from our stomach.

I certainly don't fear food and I would not hsitate for a second to feed my 4 year old grandaughter exactly what I eat at a meal. No need to coat everything in grease and fat. Better that she learns real eating habits.

If you want a negitive response from me, go ahead and post a negitive statement aimed at me. If you can be civil I can too.
Neither DS nor RNY is the best out there. The best out there is whichever is BEST for you. I did not want pieces of my anatomy removed. If medically necessary, I can be reattached. Nothing is gone. 

Actually, the RNY results in malabsorption of MORE vitamins/minerals than the DS since the RNY completely bypasses the duodenum and leaves less stomach surface, whereas the DS maintains a piece of the duodenum within the alimentary limb and keeps more of the stomach surface. See image below (note, I did NOT create this image - it bugs me that it has Roux-en-Y misspelled).

Also, the intestinal part of the DS can also be "reattached," whereas with the RNY, trying to put the somtach back together doesn't always work since the pylorus can atrophy from having been bypassed. The only part actually removed from the body during a DS is the outer curvature of the stomach, which no one ever needs back.

Now Jill, you know factual copy/paste is not allowed in their world! 

Someone apparently told you that the DS has malabsorption issues and the RnY--the "gold standard"--does not?  They lied to you.

While they're attempting to reattach your atrophied stomach--which could have ulcers and cancers and you'd never know because you can't scope it--what do you propose they do about all the documented neurological problems that are a result of the RnY?

While the Band and Bypass surgeons keep preaching "gold standard," this kind of this is being published in the neurology journals.

Neurologic complications of gastric bypass surgery for morbid obesity

Katalin Juhasz-Pocsine, MD, Stacy A. Rudnicki, MD, Robert L. Archer, MD and Sami I. Harik, MD

From the Department of Neurology, University of Arkansas for Medical Sciences, Little Rock.

Address correspondence and reprint requests to Dr. K. Juhasz-Pocsine, Department of Neurology, UAMS, 4301 W. Markham St., Slot 500, Little Rock, AR 72205-7199 [email protected]

Background: The number of bariatric procedures is rapidly growing as the prevalence of obesity in the USA is increasing. Such procedures are not without complications, and those affecting the nervous system are often disabling and irreversible. We now describe our experience with these complications and review the pertinent literature.

Methods: We describe 26 patients with major neurologic conditions that seemed causally related to bariatric surgery encountered in the neurology service of a tertiary referral university medical center over a decade.

Results: The neurologic complications affected most regions of the nervous system: encephalopathy, optic neuropathy, myelopathy, polyradiculoneuropathy, and polyneuropathy. Myelopathy was the most frequent and disabling problem; symptoms began about a decade after surgery. Encephalopathy and polyradiculoneuropathy were acute and early complications. Except for vitamin B₁₂ and copper deficiencies in patients with myelopathy, we could not correlate specific nutritional deficiencies to the neurologic complications. All patients had multiple nutritional deficiencies, but their correction did not often yield dramatic results. The best result was achieved in one patient after surgical revision to reduce the bypassed jejunum.

Conclusions: A wide spectrum of serious neurologic conditions may follow bariatric surgery. These complications may occur acutely or decades later.

And there's this:

Wernicke encephalopathy after obesity surgery

A systematic review

Sonal Singh, MD and Abhay Kumar, MD

From the Section on General Internal Medicine, Department of Internal Medicine, Wake Forest University Health Sciences, Winston-Salem, NC (S.S.); MPH Program, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD (S.S.); and Neurosciences Program, University of Iowa, Iowa City, IA (A.K.).

Address correspondence and reprint requests to Dr. Sonal Singh, Department of Internal Medicine, Wake Forest University Health Sciences, Medical Center Boulevard, Winston-Salem, NC 27157; e-mail:[email protected]

Objective: To characterize the clinical features, risk factors, radiographic findings, and prognosis of Wernicke encephalopathy after bariatric surgery.

Methods: We performed a systematic review of MEDLINE, Embase, Ovid, ISI (Science Citation Index), and Google Scholar for case reports, case series, or cohort studies of Wernicke encephalopathy after bariatric surgery.

Results: We found 32 cases (27 of whom were women) reported, from 2 weeks to 18 months after the procedure. Most patients had vomiting as a risk factor (n = 25) and presented with the triad of Wernicke encephalopathy (confusion, ataxia, and nystagmus; n = 21). Optic neuropathy, papilledema, deafness, seizures, asterixis, weakness, and sensory and motor neuropathy were also reported. Characteristic radiographic findings were hyperintense signals in the periaqueductal gray area and dorsal medial nucleus of the thalamus; radiographs were normal in 15 patients. One series from Brazil reported 4 patients (among 50 patients) with Wernicke encephalopathy; all presented with vomiting and concomitant peripheral neuropathy at a median of 2.5 months (1.5 to 3 months) after bariatric surgery. Another series identified 2 of 23 patients (both women) with Wernicke encephalopathy after bariatric surgery.

Conclusion: Wernicke encephalopathy after bariatric surgery usually occurs between 4 and 12 weeks postoperatively, especially in young women with vomiting. Atypical neurologic features are common. The diagnosis is mainly clinical, because radiographic findings are normal in some patients. Prospective studies to determine the prevalence of this problem and protocols for preventive thiamine supplementation need evaluation.

 

But who ya' gonna believe...a silly bunch of neurologists with documented peer-reviewed data or that band-factory/bypass mill guy making up his own data?

Canadian version---> who ya' gonna believe, the guy who can clear a bunch of cases off his Things To Do list in one day or those same silly neurologists?

 

First of all, let me preface this by saying that it was you who admitted to taking very few vitamins, against all good common sense at the recommendation of your medical team. I am about three weeks away from my surgery and have already purchased a multitude of vitamins which I fully intend to use. I'd actually like to live long enough to see and enjoy the benefits of my surgery. Let's talk in a coupla years and see who is the one with severe vitamin deficiencies.

While we are citing facts here lets hear your factual take on which wls surgery has the MOST vitamin and nutrient deficiencies associated with it.

In response to that lil bit o' ignorance, I'd like to point out that any malabsorbative procedure carries a risk of developing vitamin deficiencies. I know that you wont understand my next statement, but I'll make it anyway. If it comes down to taking 10 pills a day or taking 15 pills a day, I'll taking 15 if it means I get to have a superior surgery. Since you only take 4 pills a day, you probably have no idea what I'm talking about. Also, it is a major misconception (among many) that DSrs pop 100 pills a day, whereas RNYers only pop about oh....let's say 4? That's crazy talk since vitamin supplementation (besides the basics) varies from person to person whether they had a DS or RNY.

Unless you are vigilant to the point of obsession you can get into vitamin trouble. How's that for a bit of truth?

I shouldn't even dignify that with an answer, but I will anyway. Anyone with good common sense and a basic knowledge of WLS (I know, I know... common sense isn't always so common) should know that all WLS surgeries need to supplement, and that those who have had a malabsorbtive procedure should be, as you put it, "vigilant to the point of obsession." If you believe or are doing anything otherwise, you may as well get out your shotgun now.....

*ETA: That isn't fact or opinion. It's downright common sense.

Statistically speaking, the DS is the best surgery.  Statistics and studies compiled by medical professionals have determined that the DS has the best EWL %, least % of regain, best resolution of Type ll diabetes, no more bowel issues than RNY, best overall tolerance to many different foods. The best surgery for me is the one with the best record of Type ll resolution and the best record of getting and keeping off the weight.

You can argue with me and Diana and anyone else on these boards but the statistics speak for them selves!

I am all about listening to medical professionals and appreciate all the education, time and effort put into these qualified studies.

All that being said, I do not believe that the DS or RNY is right for everybody.  I see too many out there that will not / do not take their supplements. BOTH surgeries have dire consequences if you do not practice adequate supplementation.  People who do not want to supplement or are not willing to learn should not have any WLS at all, and never,ever a malabsorptive surgery!

Michele

I agree completely!

It's crazy to think that if one procedure requires me to supplement a little less than the next, I'll be exempt from deficiencies. If you cannot comply with this most basic (albeit a little confusing at times) requirement of a malabsorptive procedure, then neither the DS nor RNY is right for you.

Rnyers have issues with absorption as well but nothing compared to DSers. We still have all of our intestine from which to absorb nutrients. The ones we miss are the vitamins which are absorbed from our stomach.

Um.  We still have it (as do the DS'ers) but the duodenum is bypassed, so we don't get the benefit of it.  In fact, the malabsorption portion of the RNY gastric bypass is the bypass of the duodenum.

It would be helpful if you knew the facts...  It's especially bad when the DSers know more about your surgery than you do.

This said by a fellow RNYer.

"We still have all of our intestine from which to absorb nutrients."

So what, exactly, does she think a BYPASS is? You're not absorbing nutrients in BYPASSED intestines.

I wonder why my head hurts...oh, maybe I should stop bashing it against the wall.