confused between RNY & DS
(deactivated member)
on 5/17/10 11:09 am - Woodbridge, VA
on 5/17/10 11:09 am - Woodbridge, VA
Look at what happens at 2+ years post-op:
http://www.obesityhelp.com/forums/diabetes/3751535/If-you-are-Type-2-and-considering-WLS/
| Initial Type 2 Resolution Rates | Resolution Rate at 2+ Years Post-op |
|
| Banding | 56.70% | 58.30% |
| Gastroplasty | 79.70% | 77.50% |
| RNY | 80.30% | 70.90% |
| DS | 95.10% | 95.90% |
ScienceDaily (Mar. 11, 2009)
http://www.obesityhelp.com/forums/diabetes/3751535/If-you-are-Type-2-and-considering-WLS/
The Roux-en-Y procedure consists of making the top half of the stomach into the shape of a pouch with the use of staples or sutures. The stomach pouch is closed and attached to a Y-shaped section of the small intestine. The connection bypasses the rest of the rest of the digestive tract including stomach, duodenum, and part of the small intestine. The remainder of the stomach is transferred through a connection from the top portion of the small intestines through the rest of the small intestine, or jejunum.
Duodenal Switch is similar to biliopancreatic diversion bypass, or BPD, but instead of a small stomach pouch, a sleeve-shaped stomach is made. The surgeon attaches the final section of the small intestine into the stomach sleeve. Duodenal switch has the same result as other stomach bypass surgeries: bypassing the rest of the small intestine resulting in less absorption of calories and nutrients, causing the feeling of being full.
Duodenal Switch is similar to biliopancreatic diversion bypass, or BPD, but instead of a small stomach pouch, a sleeve-shaped stomach is made. The surgeon attaches the final section of the small intestine into the stomach sleeve. Duodenal switch has the same result as other stomach bypass surgeries: bypassing the rest of the small intestine resulting in less absorption of calories and nutrients, causing the feeling of being full.
Health is important!
Duodenal Switch is similar to biliopancreatic diversion bypass, or BPD, but instead of a small stomach pouch, a sleeve-shaped stomach is made. The surgeon attaches the final section of the small intestine into the stomach sleeve. Duodenal switch has the same result as other stomach bypass surgeries: bypassing the rest of the small intestine resulting in less absorption of calories and nutrients, causing the feeling of being full.
The Roux-en-Y procedure consists of making the top half of the stomach into the shape of a pouch with the use of staples or sutures. The stomach pouch is closed and attached to a Y-shaped section of the small intestine. The connection bypasses the rest of the rest of the digestive tract including stomach, duodenum, and part of the small intestine. The remainder of the stomach is transferred through a connection from the top portion of the small intestines through the rest of the small intestine, or jejunum.
The Roux-en-Y procedure consists of making the top half of the stomach into the shape of a pouch with the use of staples or sutures. The stomach pouch is closed and attached to a Y-shaped section of the small intestine. The connection bypasses the rest of the rest of the digestive tract including stomach, duodenum, and part of the small intestine. The remainder of the stomach is transferred through a connection from the top portion of the small intestines through the rest of the small intestine, or jejunum.
Health is important!
I'm glad you like your surgeon, but honestly, is he (or she) going to be in your life daily in three years? Because there's a much higher chance that in 3 years diabetes will be back in your life with the RNY than with the DS, as Jilly pointed out.
Nice doctors are great, but great results are better. Plus a lot of the DS surgeons are quite nice, as well.
Nice doctors are great, but great results are better. Plus a lot of the DS surgeons are quite nice, as well.
Jenn
Type 1 diabetic, 26 years
With great power (the DS!) comes great responsibility.
(deactivated member)
on 5/25/10 11:03 pm, edited 5/25/10 11:03 pm - Woodbridge, VA
on 5/25/10 11:03 pm, edited 5/25/10 11:03 pm - Woodbridge, VA
I don't think anyone was saying you were rude. It is just difficult for some of us to fully grasp why one would choose a surgeon rather than a more effective procedure that you have to live with for the rest of your life. I have not seen my surgeon since I left the hospital from my surgery more than a year ago - I do all my follow-up with my PCP or just have my surgeon's office fax me orders for labs without me having to go into their office. It's not that my surgeon is a million miles away, but, honestly, there is no need for me to see him again unless I've got intestines hanging out of my belly button or something.
A friend here on OH once made a great comparison - if you needed brain surgery, but the closest brain surgeon was across the country, would you get a boob job instead just because the plastic surgeon was right around the corner?
Personally, I thought of it more like this: diabetes is a DISEASE, and a deadly one if not treated aggressively. If I had any other serious disease, like cancer, and someone offered me a treatment with a 71% long-term success rate that I could have done 5 minutes from home or a second option that had a 96% long-term success rate that I would have to travel across the country to have done, you bet I'd be on a plane heading for that better option! But I guess that's just how strong my hatred for diabetes is.
A friend here on OH once made a great comparison - if you needed brain surgery, but the closest brain surgeon was across the country, would you get a boob job instead just because the plastic surgeon was right around the corner?
Personally, I thought of it more like this: diabetes is a DISEASE, and a deadly one if not treated aggressively. If I had any other serious disease, like cancer, and someone offered me a treatment with a 71% long-term success rate that I could have done 5 minutes from home or a second option that had a 96% long-term success rate that I would have to travel across the country to have done, you bet I'd be on a plane heading for that better option! But I guess that's just how strong my hatred for diabetes is.
To Jillybean and Jenn,
Just curious as to what led to your decision to have DS vs RNY. Did you make a pro and con list? Was the choice so obvious to you both? It seems the more resarch I do, the more confused I become. Quite honestly, each WLS I reviewed made their case on why that one is the best surgery, with the best success rate. Your kind guidence would be most appreciated.
Just curious as to what led to your decision to have DS vs RNY. Did you make a pro and con list? Was the choice so obvious to you both? It seems the more resarch I do, the more confused I become. Quite honestly, each WLS I reviewed made their case on why that one is the best surgery, with the best success rate. Your kind guidence would be most appreciated.
(deactivated member)
on 5/27/10 10:06 pm - Woodbridge, VA
on 5/27/10 10:06 pm - Woodbridge, VA
As soon as I learned about the DS, it was very obvious to me which was the right option for me. Before I knew about the DS, I didn't want to have WLS because I thought the only option were the band and RNY, and I thought they both sounded pretty horrible to live with. Being type 2, of course, I didn't even really consider the band, so I was focused on RNY. My fears/hesitations about the RNY:
- potential dumping syndrom
- potential reactive hypoglycemia
- man-made stomas known to stretch over time
- malabsorption of calories only lasts about 1-2 years, so then you're back to absorbing all the calories you eat again, so what was the point of having only temporary malabsorption of calories?
- potential for food getting "stuck"
Also, I had known multiple people in person who had had RNY, and while they were mostly successful weight-wise, many of them looked, somwhat sickly, as in pale or rough looking skin, lots and lots of hair loss, etc. I now know that this is likely because they were given very poor supplementation advice, but when I met a lage group of local DSers in person, they all looked so healthy (I also now know that DSers, in general, tend to be much more proactive and directly involved in their own supplementation plans).
So, when I discovered the DS, of course, I was first scared off by how "invasive" and "complicated" it was. But once I got past that silly hype and did real research, I discovered the following about the DS:
- higher initial success rate for weight loss than RNY
- higher long term success at keeping weight off than RNY
- higher percentage of type 2 diabetes resolution in the short term
- higher percentage of type 2 diaetes STAYING resolved long term
- no bypassing of the pylorus (read: no dumping nor hypoglycemima as a result of the surgery)
- no man-made stomas to stretch out over time
Neither procedure comes without risks or potential side effects, so, of course, I started hearing about the gas and diarrhea issues with the DS. Funny, though, when I lurked on the RNY boards, I would see threads about these topics frequently, so I knew it was a potential risk with either procedure, just that it was stressed more about the DS as basically a scare tactic. The difference was that the DSers seemed to always have suggestions for preventing these issues. I noticed very quickly that the DS community, in general, seemed very much more educated about their procedure and how to live with it, including how to prevent potential issues. That's not to say all RNYers haven't a clue, but I think many end up with the RNY because it's so much easier to get without research (just run to your nearest WLS clinic, they all do RNY!), whereas most people get the DS because they've DONE research and sought it out.
It's funny when I pot studies showing the better results on type 2 diabetes with the DS, I often get a comment from someone who says you can find a study to support just about any point you're trying to make. Funy thing is, I have yet to find a single study that directly compares the RNY and DS for diabetes and concludes that the RNY is the better choice for type 2 diabetes. Some studies lump the RNY and DS together as "malabsorptive" procedures, so they imply that the RNY and DS have the same success rate in resolving diabetes, but I have never seen one that concludes that the RNY is better at resolving diabetes than the DS.
So, for me, it was obvious. You're taking vitamins 3-4 times a day with both procedures, so that wasn't a factor in my mind. Oh, also, you can take NSAIDs with the DS since there is no blind stomach, but that also wasn't a factor for me because I'm allergic to NSAIDs anyway.
- potential dumping syndrom
- potential reactive hypoglycemia
- man-made stomas known to stretch over time
- malabsorption of calories only lasts about 1-2 years, so then you're back to absorbing all the calories you eat again, so what was the point of having only temporary malabsorption of calories?
- potential for food getting "stuck"
Also, I had known multiple people in person who had had RNY, and while they were mostly successful weight-wise, many of them looked, somwhat sickly, as in pale or rough looking skin, lots and lots of hair loss, etc. I now know that this is likely because they were given very poor supplementation advice, but when I met a lage group of local DSers in person, they all looked so healthy (I also now know that DSers, in general, tend to be much more proactive and directly involved in their own supplementation plans).
So, when I discovered the DS, of course, I was first scared off by how "invasive" and "complicated" it was. But once I got past that silly hype and did real research, I discovered the following about the DS:
- higher initial success rate for weight loss than RNY
- higher long term success at keeping weight off than RNY
- higher percentage of type 2 diabetes resolution in the short term
- higher percentage of type 2 diaetes STAYING resolved long term
- no bypassing of the pylorus (read: no dumping nor hypoglycemima as a result of the surgery)
- no man-made stomas to stretch out over time
Neither procedure comes without risks or potential side effects, so, of course, I started hearing about the gas and diarrhea issues with the DS. Funny, though, when I lurked on the RNY boards, I would see threads about these topics frequently, so I knew it was a potential risk with either procedure, just that it was stressed more about the DS as basically a scare tactic. The difference was that the DSers seemed to always have suggestions for preventing these issues. I noticed very quickly that the DS community, in general, seemed very much more educated about their procedure and how to live with it, including how to prevent potential issues. That's not to say all RNYers haven't a clue, but I think many end up with the RNY because it's so much easier to get without research (just run to your nearest WLS clinic, they all do RNY!), whereas most people get the DS because they've DONE research and sought it out.
It's funny when I pot studies showing the better results on type 2 diabetes with the DS, I often get a comment from someone who says you can find a study to support just about any point you're trying to make. Funy thing is, I have yet to find a single study that directly compares the RNY and DS for diabetes and concludes that the RNY is the better choice for type 2 diabetes. Some studies lump the RNY and DS together as "malabsorptive" procedures, so they imply that the RNY and DS have the same success rate in resolving diabetes, but I have never seen one that concludes that the RNY is better at resolving diabetes than the DS.
So, for me, it was obvious. You're taking vitamins 3-4 times a day with both procedures, so that wasn't a factor in my mind. Oh, also, you can take NSAIDs with the DS since there is no blind stomach, but that also wasn't a factor for me because I'm allergic to NSAIDs anyway.
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