Ds

Ds

I can not answer your question since I had the sleeve surgery done.  But I would suggest posting your question on the individual surgery forums.  You should receive a better response from a wide variety of people.

Good luck.

Thank you. I will try that.

From everything I have read, the DS sounds like a better choice for you. Have you met with a surgeon yet? If there are any DS surgeons near you, I would go for a consult. With a BMI that high, you may have to lose weight before any surgeon will operate. Some may do the sleeve first and then do the switch later.

Thank you for your input ladies. I went to a seminar and spoke with one surgeon who in general who has done wls on patients over 800 llbs and he did not require weight loss before hand. He does not do DS though. I know of another who does do DS but not sure of his requirements. I put in a call to his office and should hear back next week. I don't want to pay for a consult until I am sure of the doctor. It makes no sense to make an appointment if they have a weight or bmi limit. I was sort of bummed that the first doctor doesn't like DS because I really liked him and his staff was great. If DS is not an option because of my weight, I will definitely go to the first doctor for bypass as he was comfortable with people my size. 

My BMI started out in the 60's but was in the 50's when I had lap RNY.  (some surgeons have a BMI limit before they will perform WLS)  Recovery included three nights in the hospital, three weeks of slow moving around the house with two long naps per day. Pain levels never were over a six on the 1-10 pain scale. I slept in a bed with lots of pillows the first night home.  Around three months, I started feeling comfortable with the post-op lifestyle.  Mentally, the entire first year was tough; harder than physical healing as weird as that may sound.   I felt comfortable with the RNY because my surgeon had performed thousands before.

Getting surgeons I feel comfortable with is important to me as well. That's why I want doctors who mainly if not only do bariatric surgery. Both doctors I'm thinking about have also performed thousands of surgeries. I will definitely choose and be ready to start by May. 

There is a DS board on here and there may have been someone who's had it done open vs lap on there.  I know Lora on the RNY board had her RNY open and if you PM her I'm pretty sure she'd share her experience with you.  I think Shelly (Eggface) had hers open too, but I could be wrong on that.  

From what I understand of the differences between RNY and DS is that the stomach on the DS is a sleeve rather than a pouch and more of the intestine is bypassed. The extra stomach is removed, so you don't have a blind stomach and you still have access to your pyloric valve to control the passage of food into the intestine you still have access to.  Since more of the small intestine is bypassed, your caloric malabsorption will last a lifetime, which is a double-edged sword.  As with RNY, you absolutely MUST keep up on your vitamin supplements and your blood work to avoid complications.

My RNY was a lap procedure and the recovery wasn't too bad.  I was tired for a long time, but I feel like I was back to feeling like myself around a month or so after.  

Let us know how you progress!  :D

Jen

With your BMI, I would not look at anything other than the DS if I wanted to get to anywhere near a normal BMI. There are of course studies that show DS has the best weight loss, best maintenance of that loss, and best resolution of co-morbidites (especially type 2 diabetes and high cholesterol) but also studies showing it is especially good for higher BMIs over 50. 

There are also studies that show the risk factor is actually about the same between RNY and DS. What seems to be a real factor as far as risk is the surgeon, but even those stats can be misleading, as many "cherry pick" and don't operate on the high risk folks, to keep their stats good.  You need both a surgeon that actually knows the DS (not just who claims to know it because they trained along a surgeon that could do it) and one that deals with patients your size. 

What I consider drawbacks - the need to supplement (and it can be a lot), and get labwork done regularly and follow it to determine if more or less supplementation is needed, and possibly needing to adjust diet to reduce carbs, lactose, or whatever to keep bathroom issues in check all apply to both DS and RNY. Supplements will be a fact of life, and so may be avoiding or limiting certain foods.

I don't know where you are, but if near CA I'd start with Rabkin or Keshishian. They both take the more complicated cases, and have stellar reputations. What part of the country are you in?

If my BMI were that high, I would go for the DS without question because it would give permanent caloric malabsorption rather than caloric malabsorption that lasts only 18-24 months.  You will likely need the malabsorption for longer than that in order to lose sugh a large amount of the excess weight. I started with a BMI of 57 and strongly considered the DS, but I was really concerned with the additional lack of vitamin absorption.  It has the best statistics for weight loss and maintenance, but it also has two significant drawbacks: the vitamin supplementation required and the potential for some nasty digestive side effects.

If you choose the DS you will absolutely HAVE to commit to following the significant post-op vitamin regimen (for life) in order to avoid vitamin deficiencies and health issues related to them.  You also need to commit to following a vitamin regimen for RNY... It is just greater with the DS. The vitamin recommendations of the surgeons that I work for Re based on ASMBS guidelines and require DSers to take 6 doses of vitamins a day (and RNYers 4).

As Jen said, my RNY was open.  I was on pain meds for a couple of weeks (one refill on the pain meds), and was off work for 7 weeks (my incision was oozing, so I got an extra week while we made sure it was not infected...  it continued to ooze for 9 weeks total).  I carried a lot of weight in my belly, so the incision was 8+ inches long, from my breast bone to my waist. Getting around with such a large body and with such a large incision was a challenge for the first two weeks and I had to sleep in a recliner for several weeks (almost 4 weeks, I think) because it hurt too much to lie flat and because I would have had a REALLY hard time getting out of bed without help.

I firmly believe that everyone CAN be successful with either surgery, but it is important to make a decision for a surgery that is best suited to your needs and that you can live with long term.  Good luck with your decision.

Lora