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Topic: RE: confused between RNY & DS
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 5/25/10 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
Topic: RE: confused between RNY & DS
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.
Topic: RE: confused between RNY & DS
PLease understand that I am not trying to be rude!!! I could say the same about a DS surgeon gonna be in my life in 3yrs... I am aware that my diabete's could come back..My couisin is 8yrs RNY, her"s hasnt resurfaced yet, I pray it's in the genes...
Topic: RE: confused between RNY & DS
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.
Topic: RE: vegan?
As of 12/10/10 CW: 150 pounds Lost: 52
I had the VSG. When I eat vegan my blood sugars are great but it is a very hard diet to maintain. I stick with vegetarian and get the same results.
I eat eggs about 3 times a week, lots of greek yogurt, tofu, spinach, salads and also berries 1/2 cup. I also buy light baby bel cheese. Rarely eat carbs.
I do not know how it would work for you since you have an RNY. Since I started to eat this way, i feel better and my A1C has dropped so has cholesterol. If you go the vegan or vegetarian route you have to plan your meals in advanced otherwise one can tends to over eat on carbs. Best of luck to you
I eat eggs about 3 times a week, lots of greek yogurt, tofu, spinach, salads and also berries 1/2 cup. I also buy light baby bel cheese. Rarely eat carbs.
I do not know how it would work for you since you have an RNY. Since I started to eat this way, i feel better and my A1C has dropped so has cholesterol. If you go the vegan or vegetarian route you have to plan your meals in advanced otherwise one can tends to over eat on carbs. Best of luck to you
(deactivated member)
on 5/23/10 10:48 pm - Woodbridge, VA
on 5/23/10 10:48 pm - Woodbridge, VA
Topic: RE: Which surgery would be best for my diabetes?
If you're a "numbers girl," research the DS for diabetes. I have many studies and articles in my profile and also posted here:
http://www.obesityhelp.com/forums/diabetes/3751535/If-you-are-Type-2-and-considering-WLS/
You're right that initial resolution rates for RNY and VSG are in the same ballpark (most studies will say there is not a "statistically significant difference," but the VSG results are typically just a fraction of a percent to two percent lower than the RNY). The DS still beats them both. Of course, I found one study that concluded that the reduced insulin resistance as a result of VSG was merely a direct result of dietary changes and weight loss, whereas I found another study concluding that the insulin resistance post-VSG is likely due to a hormonal change (it didn't specify ghrelin, but that would be my guess). The study I was involved in at Johns Hopkins was leading to the conclusion that it was dietary changes and weight loss
I just did a quick search on PubMed, and it looks like there are a lot of abstracts for currently ongoing studies regarding the VSG and diabetes, which is good because there is not a whole lot of info out there right now, and really none that is long-term. Most of the studies I've found compare the VSG to the band since they are both restrictive-only procedures, and it's hard to compare the results of one study to the results of another study because they don't all follow the same standards, including their definition of "resolution" of diabetes. Heck, in my quick search on PubMed, I found one study that defined "resolved" diabetes as having a A1C of <6.0 and another that defined "resolved" diabetes as having a fasting glucose level of <126 and an A1C of <6.5. So, different standards even across VSG studies.
http://sites.google.com/a/clos.net/mini/sleeve-gastrectomy-versus-gastric-bypass-diabetes (I don't trust the MGB, but different surgeons have different definitions for MGB, and this was in Taiwan, so I'm wondering if it's different from the shady stuff going on in Vegas)
http://www3.interscience.wiley.com/journal/117992315/abstract
http://www.obesityhelp.com/forums/diabetes/3751535/If-you-are-Type-2-and-considering-WLS/
You're right that initial resolution rates for RNY and VSG are in the same ballpark (most studies will say there is not a "statistically significant difference," but the VSG results are typically just a fraction of a percent to two percent lower than the RNY). The DS still beats them both. Of course, I found one study that concluded that the reduced insulin resistance as a result of VSG was merely a direct result of dietary changes and weight loss, whereas I found another study concluding that the insulin resistance post-VSG is likely due to a hormonal change (it didn't specify ghrelin, but that would be my guess). The study I was involved in at Johns Hopkins was leading to the conclusion that it was dietary changes and weight loss
I just did a quick search on PubMed, and it looks like there are a lot of abstracts for currently ongoing studies regarding the VSG and diabetes, which is good because there is not a whole lot of info out there right now, and really none that is long-term. Most of the studies I've found compare the VSG to the band since they are both restrictive-only procedures, and it's hard to compare the results of one study to the results of another study because they don't all follow the same standards, including their definition of "resolution" of diabetes. Heck, in my quick search on PubMed, I found one study that defined "resolved" diabetes as having a A1C of <6.0 and another that defined "resolved" diabetes as having a fasting glucose level of <126 and an A1C of <6.5. So, different standards even across VSG studies.
http://sites.google.com/a/clos.net/mini/sleeve-gastrectomy-versus-gastric-bypass-diabetes (I don't trust the MGB, but different surgeons have different definitions for MGB, and this was in Taiwan, so I'm wondering if it's different from the shady stuff going on in Vegas)
http://www3.interscience.wiley.com/journal/117992315/abstract
Topic: RE: Which surgery would be best for my diabetes?
Can you direct me to studies that show stats for resolution of Type 2 diabetes with both RNY and VSG? I've seen two studies that show almost identical numbers. I'm a numbers girl.
Edie
Approved 8-1-11, Surgery 8-22-11 SW 231, Goal 140, CW 165
(deactivated member)
on 5/23/10 2:25 am - Woodbridge, VA
on 5/23/10 2:25 am - Woodbridge, VA
Topic: RE: Which surgery would be best for my diabetes?
The RNY DOES do a better job than the VSG for resolving type 2 diabetes, and the DS does a better job than the RNY. The trouble with the VSG right now is the lack of good long-term studies. The VSG will basically only help your diabetes if it is directly weight- and diet-related. The RNY and especially DS actually inflict a bit of metabolic change via the intestinal reconfiguration. In Europe and in trials in the US, they actually do JUST the intestinal part of the DS (without making the stomach smaller) as a treatment for type 2s who are NOT obese. I don't see how a VSG might ever help a non-obese type 2.
Many BCBS plans DO cover the DS. Mine did. But it depends on your plan. There are SO many BCBS plans out there. I had BCBS of NJ.
Many BCBS plans DO cover the DS. Mine did. But it depends on your plan. There are SO many BCBS plans out there. I had BCBS of NJ.
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