Any DS'ers who wish they had gotten the RNY

 I'm not Hala, but it stands for reactive hypoglycemia, and some doctors are calling it late dumping. Many RNY folks are developing problems with it after a while.

 Ah ha! Thank you! THAT, I have heard of.  Just didn't recognize it in the RH "format" :D

RH - I do believe that for keeping the weight off and maintaining - the RH is one of the worst side effects of RNY.  MI do believe a lot of us, RNY's know we have it, and so many do not even realize they have it.  The body overreacts to carbs - sugar in our diet and the body makes too much insulin.  That also can create a hyperinsulemia state.  Too much insulin in the blood stream will be responsible for gaining weight even on a very low calorie diet.  Insulin is the hormone responsible for taking the sugars to cells and for storing any extra calories into fat cells... Also - Too much insulin may prevent the body from releasing fat from fat cells and burning the fat. That may create a bad cycle - someone eats foo with carbs, the insulin gets high, start storing  - putting away the sugar from the blood, the blood sugar drops, person gets really hungry and lightheaded, need to eat some carbs to bring the sugar up, that causes the release of insulin, and so on...  Low blood sugar is very dangerous. It may cause so many issues, up to coma and death.    Something you do not want to mess with.
In a milder case - the BS drops below the body "normal" level making the person hungry, almost ravenously hungry... The adrenaline gets released and it is fight and flight response... basic - eat or die... body reaction.  
I wonder how many RNY will get RH dioagnosis if they are properly tested.  Probably a lot. 80-90%?

Now - some DS people get that too... but then some people who never had WLS can get that.

 I didn't know there was a test for this. I'm going to talk to my GP about it. Thanks for the info. :D

For such a poor study, this one has received a lot of press. Let's take a closer look at some of the issues:

1. very small number of patients in both groups

2. surgeons admit they had little/no prior experience with the DS, thus putting them in the surgical learning curve for this operation, but NOT in the learning curve for gastric bypass

3. did you look at their vitamin/supplement program? Totally inadequate! They even used calcium carbonate, not calcium citrate, woefully small amounts of everything, etc. And then surprise, surprise! Patients had nutritional deficiencies. It was no surprise to any educated DS patient.

There are longterm follow--up studies out there, including a 10 year follow-up of almost 1,000 Ds patients by Hess and a 15 year follow-up of a large group of patients by Marceau. The rate of nutritional deficiencies was very low - slightly higher than with gastric bypass, yes, but in most cases due to noncompliance by the patient (which is usually true for gastric bypass patients with nutritional problems also). The rate of needing revision for nutritional problems or excess weight loss is very small, and when problems do occur, remedies are available.

Is the DS perfect? No. No wls is perfect. Are there potential complications and side effects? Yes, again, true for all wls. But let's look at the results. The DS has the highest percentage excess weight loss of any wls, the best maintainence of that weight loss, and the best resolution of all comorbidities except GERD. What is the point of having ANY wls if you don't get good results? What isi the point of losing weight if you gain it back?
    And let's look at lifestyle. DS patients can eat a more varied diet without fear of dumping or reactive hypoglycemia. We can eat fat, and cook with fat, without fear of weight regain. This does NOT mean that unhealthy eating is required or recommended, just that we have more freedom. We can take NSAIDs. We can drink liquids with our meals. Overall, it's a much more normal way of eating.

I've been on the DS forum for over 6 years. I've seen way too many people with gastric bypass seeking revisions. And sadly, many of them will be stuck with a failed gastric bypass due to either financial barriers or because their bypass was done in such a way that it can't be safely revised. If you are happy with your surgery, that's great. But you would be amazed at how many people have regrets that they didn't research more, or that they just went along with what their insurance would pay for.

Larra

 I am so glad I had the DS 18 months ago.  I am still slowly loosing weight and I'm 6 pounds from goal.  I don't eat abnormal amounts of fat but I do no****ch fat content.  I simply do not absorb 81% of the fat I eat. So all those so called 'toxins' are not absorbed either.  What I do watch are carbs.  I still really enjoy them but I do make sure that my meals are protein rich.  Carbs are second fiddle.

Deciding to have a surgery that allows me to keep my naturally functioning pylorus valve while also having malabsorption has been not only a decision I do not regret, but a thoroughly educated one decision as well.

With my slightly larger sleeve (5oz) I eat what I would consider a normal sized meal.  When I am out with friends and family no one would ever know that I've had surgery.  Most of the time I do have leftovers but just as a normal sized person with normal eating habits would have.  I do not require a children's menu or low fat, fat free menu.  There is no shame chunky bleu cheese dressing on the ol' salad!  I'm sure there are many RNYers that will agree with that too :)

I eat a lot of dense proteins.  I love steak, chicken, fish, eggs and yes, bacon.  I love salad.  I love veggies.  I love cheesecake (did I just say that out loud?)

Right now I a hooked on brie on fig bread with a touch of pumpkin butter, grilled with olive oil until melty.  Dense artisan crusty type breads do not give me gas like cheap sliced white bread.

OK now I'm rambling. I do not regret having my DS.  I shutter when I think of how close I came to having an RNY (I had been approved and had a date even)   it's never too late until you're on the table.
~GG

I'm so glad I pushed to have the DS. I was originally scheduled to have the RNY but after reading these boards, I decided that for me, the DS was best.

Due to the cost of the cholesterol meds, I stopped taking them late last fall...figured I was going for WLS, why get a 90 day supply? My total cholesterol back then on diet alone was over 200. I had some new labs done this month...my total cholesterol still on diet alone but with a DS is 179. I've NEVER been able to get below 200 before a DS on diet alone.

What I did not want with the RNY was the inability to EVER take NSAIDS, the chance of reactive hypoglycemia, or the chance of dumping. And even tho the odds are only 30% for dumping, the odds were still too high.

The ONLY part I regret is not having had WLS sooner, altho if I had, I probably would have had the RNY and that I WOULD regret.

Each surgery is best for individual people but over all, the regrets aren't coming from DS'ers...we seem satisified with what we chose...the regrets board and revision board is full of others, (except maybe VSG'ers who seem to like their surgery as well) 

The assumption that a DS'er eats lots of fat is for good reason...most of us suffer from constipation if we don't eat fat. And I personally hate the idea of being constipated...

Liz

Edited a typo

Doesn't RNY cure reflux?  That's the only advantage I can think of that RNY might have over DS.

The way I understand it, the pyloric valve is either removed or altered when you have RNY.  This allows food/drink/acid to flow right into intestines rather than backing up into the esophagus.  The down side that I'm aware of is that having food move that quickly can cause reactive hypoglycemia in some people. 

There may be someone else who can clarify whether my understanding is correct.  I'm not having either procedure, so while I've researched them both, I don't have the deep understandng that others have.

Amy, I've read that the RNY resolves GERD...but the odd thing is...I had far worse GERD pre-op than I do now...so the DS can also resolve it.

In a RNY, your stomach is altered so that all you have is a "egg size" pouch at the top and the rest of your stomach is moved off to the side. Your intestines are reattached to your pouch using a stoma. The pyloric valve is left attached to your blind stomach and is not usable in that configuration. Your pyloric vavle is what was intended for you to use to control food going into your intestines...without it, the stoma is left to take over the task and can easily stretch allowing mush more thru than intended. A pouch CAN be stretched out to 8-10 oz over time.

And in a proximal RNY, you have far more small intestines left to start absorbing food (altho NO vitamins/minerals) after 18-24 months. You lose the upper part of your small intestines but not the middle, the Jejunum and since a small intestines (unaltered) can exceed 20+ feet www.chp.edu/CHP/organs+intestine that still leaves quite a long area for absorbtion. In a DS, we reconnect in the bottom portion (the Ileum) and only for 75-200 cm. Mine is fairly long at 175 cm.

If you look up my blog on my profile, you will see all I have found on reactive hypoglycemia (or as some surgeon's are calling it: Late Dumping), the dates of the posts are May 20th and 26th.

Good luck with your research and decision.

I had read that too, but in my case the DS resolved my reflux. Even if it hadn't, I'd just take an acid reducer, rather than get the other things that my come with the RNY.

I've also read that smaller sleeves may contribute to the reflux, and many of us had hiatal hernias repaired with the WLS, which also may solve the problem.