Decisions Decisions

I went with the 'best kept secret' in the WLS world---the Duodenal Switch.

I chose the DS for a lot of reasons. I knew that I had a very 'thrifty' metabolism, one that has always tried to hang on to every possible calorie. Any time I dieted, it quickly caught on and got even more thrifty. That made the idea of always and forever only absorbing a fraction of the calories I eat very appealing. (Dsers malabsorb calories forever, especially calories from fat. Fat is pretty much a 'free food' for us.)

I also knew that the DS had the very best long-term, maintained weight-loss stats, and the best stats for resolving or preventing things like diabetes and high cholesterol. Both run in both sides of my family, and I wanted the best possible chance of not getting them.

And I knew I would always need to be able to take NSAIDs. Not just for the extensive arthritis I've had since 20---I'm 56 now---but for everyday things, like headaches, sprains, menstrual cramps, fever, etc. NSAIDs are big no-nos after the RNY/gastric bypass.

It's important to choose the form of WLS that's the very best for YOU. In order to do this, you need to understand ALL of your options---and I don't just mean the options your current surgeon offers you. It's far easier to change surgeons now and get the best WLS for you than it is to go with whatever your surgeon and insurance company want to give you, and be back looking for a revision in a few years.

While you're researching, be sure you visit the Revision board right here at OH.

I made a list with all the pros and cons that mattered to me to help me decide. 

For me, I wanted;

Best weight loss stats (DS)

Best maintenance of weight lost (DS)

Best chance at resolving co-morbs like high cholesterol, insulin resistance, metabolic problems like PCOS (all DS)

Needed to be able to take NSAIDs for pain sometimes (cannot with RNY, but can with sleeve or DS)

Did not want risk dumping or reactive hypoglycemia (both common with RNY)

Had to take lots of vitamins (imperative you take supplements with both DS and RNY, sleeve much less so)

So for me, everything pointed to the DS with vitamins being the big drawback, although having gotten to throw away ALL my prescriptions for EVERYTHING, except my thyroid (can't be helped by weight loss) those vitamins are the best trade off I've ever made!

In my case, I had two options: RNY or the sleeve.

Next, it was my medical history that came into play. Because I have severe psoriatic arthritis and I require NSAIDs, I would not have been able to take those post-op if I had RNY. However, as long as I use an anti-acid medication (prescription), I can keep taking NSAIDs with the sleeve surgery.

That made the sleeve my best option, hands down. Luckily I didn't have problems with acid reflux before surgery, because the sleeve can aggravate that, so my surgeon agreed. And I had my surgery in February.

I also learned while doing my research that long-term success rates are similar for both RNY and sleeve patients.

Keep in mind that I'm in Ontario Canada, and the DS isn't covered by the provincial health care plan, while the RNY and the sleeve are. The DS was not an option for me.

Yes it is, and was, covered by OHIP. I know a few DS patients who had it in Ontario.

When we retire in 8-10 years, my husband and I plan on taking our 47' sailboat to the Caribbean for a few years and enjoy life.  My surgeon recommended the sleeve as there are less requirements for monitoring and supplements since we will be away from conventional medicine at times.  Just my two cents!