DS vs RnY

What made you decide to have the DS instead of the RnY or any of the other options?  I'm just starting my journey and really looking for input from anyone that has some to offer!!!

Thanks in advance...

I was originally on track to have RNY back in 2002, but got derailed after preop testing revealed that I had pulmonary hypertension. It's a long story, but it's on my profile if you'd like to read about it.

Even though I was off the track for RNY, I continued to attend the program my then-surgeon required of all his patients. I'd paid for it, so I figured I could benefit from it anyhow :-).

I saw some disturbing trends there. This was a big group, as several surgeons sent patients to it. There was, of course, a cadre of very successful patients (all RNY). They finished their year of program and went on with their lives, and as far as anyone knew/knows, all is well.

There were a surprising number of people, though, who fought and fought and fought to comply with what was expected of them, and the weight didn't come off well. At every meeting, there was word of someone else in the hospital with this or that problem--usually an ulcer or a stricture.

I listened to stories of dumping episodes, of getting food stuck episodes, of the mental/emotional challenges of having to live on highly restricted diets.....and I thought, "There's not a chance in hell I could live with this." (I should add that I have a major vomiting phobia. I'll do just about anything to not vomit. Not a good thing in some cases.)

Well, time passed, I got fatter and sicker, and eventually (again, story in my profile), it came out that the pulmonary hypertension was caused by the fat on my torso squashing my heart and lungs. It went from, "You cannot have any surgery at all," to, "You must have surgery or die."

I came back here to OH, feeling desperate because the lap band wouldn't give me enough weight loss to have any real hope of curing what was ailing me, and the RNY seemed to me like foolish butchery for not enough good results.

Someone told me then about the duodenal switch, invited me over to the DS board, which at the time was pretty much brand new, and the rest was history.

What I like about the DS:

1. 98% cure rate for type II diabetes. This was a major biggie because I had very bad diabetes.
2. Normal stomach anatomy and function is maintained. The stomach is reduced in size, but the normal stomach outlet, the pyloric valve, remains intact and functioning. There is no "stoma" with the DS or the vertical sleeve gastrectomy (VSG).
3. The intestinal changes that are done in the DS "jump start" the body's metabolism. Mine was shot to hell from a lifetime of PCOS, dieting and other factors.
4. I'd already done many years of low fat, low carb, highly restrictive dieting and I knew I sucked at it. The DS gives an eating quality of life that I find easy to live with: eat a primarily animal protein based diet. I'm a happy carnivore :-). I had to learn to restrict my carb intake, but it was a lot easier to do when I could eat meat, cheese, fish, eggs, etc. with abandon, with little regard for fat content. (DS'ers only absorb about 20% of the fat they eat, so for most of us, fat is almost a "free" food.)

I felt so strongly about the superiority of the DS to any other procedure that I traveled and paid out of pocket to have it done, rather than have the RNY done fifteen minutes from home and covered by insurance. It's been three years, and so far, so good :-).

Please come over to the DS board and visit with us there. Lots of folks will be happy to tell you about their experiences.
 

Years ago when I started to do research about WLS I was first attracted to the RNY. I had read a couple of blogs of people who had it done and seemed to be doing quite well. I had a friend who had the Bilio-pancreatic Diversion (w/o the DS part) and had some horrible post-op complications. In his case it turned out to be because his surgeon was a hack. Another friend used the same surgeon about the same time, was promised a DS and actually recieved a BPD. There was a class action lawsuit forming against this surgeon when he died of a heart attack. I only mention those things because the surgeon you choose is as important as the procedure itself. Research doctors too.
Back to the procedure...The more I looked the more I didn't think the RNY would be for me. I read about the possible post-op complications and the relatively low rate of success with us seriously overweight folk. I was 450 pounds and I'm only 5'8". I then found out about the DS while researching the BPD.
Once I learned that it had the restrictive component that was less than the RNY and a malapsorptive component greater than the RNY I was sold. I thought it would provide me a more normal way of eating and a better rate of success. I'm only about 8.5 months post-op now but my results have been incredible. I can eat anything although I have changed my habits. I eat almost no sugary foods, eat little high carb foods, and lots of protein. I'm blessed because I can already handle carbonated beverages. I sooo love diet cherry Dr. Pepper :)
Best of luck on whatever path you choose. It's a life changing experience so make sure it's the change you REALLY want.
Mike

I had the band..."less invasive" and all that BS...until it malfunctions.  And I knew--IRL--many people who had had wls.  We met for lunch or dinner and for support group meetings (I only went to one or two of those) and out-of-town get-togethers.  There were LOTS of still-fat banded people...most of them, in fact were still quite heavy.  

The RnY people appeared to have a better weight loss result...but they ate little dibs and dabs of things with no sugar and no fats.  (Still, when I go out with RnY friends, I order whatever I want and they get to taste my mojito or my dessert if there are sugars and fats involved.)  

The DS people seemed to be doing better at maintaining their weight loss and their lives seemed the most normal.  Do not misunderstand...I am not saying that the DS is foolproof.  I know several DS people who have not lost as much as they had hoped to lose or who have regained some.  

In fact, I am in both of those categories.  I went from a BMI of about 52, to right around 30 and then back to about 33.  So I am obese.  My "excuses" are that I was older (they don't tend to do as well), that I was a revision (they don't tend to do as well) and that I have done NOTHING...AB-SO-FREAKIN'-LUTELY NOTHIN'...to "help" my DS help me lose weight.  I eat what I want when I want to.  I eat crap.  I eat to comfort myself and lately, there have been many reasons--things like surprise overnighters with Mom in hospital ERs--where I eat whatever looks good from the cafeteria selections...not what looks healthy.

The DS is the best for weight loss, that is a proven fact.

But the reason I think it was a good fit for me is that with the band I NEVER felt full or satisfied.  NEVER.  And while the RnY offers both restriction and malabsorption, it is PRIMARILY a restrictive surgery.  A teeny, tiny pouch instead of a stomach.  And teeny, tiny pouches stretch over time.  The DS offers a smaller-than-normal stomach, which also stretches over time, but most of the malabsorption continues.  Which means that all I have to do is "cave in" to eating steaks and eggs and whipped cream without the other carbs and i'll be fine.

 Hi Fluxie,

Good on you for researching all your options. I have (or had?) insulin-resistance and a crappy metabolism. Restriction diets had not worked for years with me, and based on that, I ruled out the Lap Band and the VSG pretty much right away.

For me, it came down to the DS and RNY, and here are the main reasons I chose DS.

1. Best percentage of excess-weight loss, and best chance of maintaining that loss. If you check out the chart here: www.aace.com/pub/pdf/guidelines/Bariatric.pdf, on page 10, these are the reported percentages of excess weight loss with RNY and DS:
--1-2 years: RNY 48-85%, DS 65-83%
--3-6 years: RNY 53-77%, DS 62-81%
--7-10 years: RNY 25-68%, DS 60-80%

I did not like the 7-10 year numbers for RNY! Additionally, here is a study from 2006, showing that the RNY had about a 35% failure rate for those with a starting BMI over 50 (meaning did not maintain even 50% excess weight loss): 
journals.lww.com/annalsofsurgery/Abstract/2006/11000/Weight_ Gain_After_Short__and_Long_Limb_Gastric.18.aspx

I know the bad luck I've had with diets, etc in the past. I wanted the odds in my favor where surgery was concerned.

2. Best rate of resolution for most of my co-morbid conditions. Before surgery, I had PCOS (with insulin resistance), Sleep Apnea, Hypertension and GERD. The most troubling to me were the PCOS and Sleep Apnea. After researching, I found that the DS had a better chance of improving everything but the GERD. (RNY has statistically a better resolution for that.) I was willing to take a chance on the GERD, and lucky for me, it has already resolved. My sleep apnea is now gone, as is my hypertension, and all signs point to major improvement with my PCOS too.

3. Can take NSAIDS (Advil, Aleve, Aspirin). Tylenol has never done much for my pain, and I hated the idea of not being able to take NSAIDS for life with RNY. My mom has osteoarthritis and can't take NSAIDS for another reason - she recently had a bought of severe pain and had to take morphine and dilaudid, although NSAIDS would have worked better and had much fewer side effects. I wanted to avoid that fate if at all possible.

4. No dumping syndrome. Dumping sounds horrible to me, and I didn't want to chance that experience. I've also seen post-RNY folks who dump on unexpected foods. I wanted to be able to enjoy an occasional sweet treat post-op. 

5. Fully functional, though smaller stomach, no blind stomach, no pouch/stoma. I really didn't like the idea of a blind, unscopeable stomach that could develop ulcers, etc. I also like the function of the pyloric valve vs. the man-made stoma.

Those are the main things. There were other factors too, including the fact that I prefer the post-DS diet, but that was all quite secondary to the stuff on my list.

Hope that helps, and best of luck with your research!

Jenna

I actually was approved for RNY and went to get my date scheduled but had pre-op blood work done wherein my RNY surgeon found my liver levels elevated and he postponed my surgery for 3 months....thank goodness....it was while I was waiting that I heard about the DS!  There was no turning back....

As to my reasons I chose the DS (partial list to follow)

1.  No blind stomach.  The thought of part of my stomach left behind that couldn't be scoped for issues scared me!

2.  Eating more normal.  By normal I mean like in types of foods and quantities more like a normal person (not to be confused with my pre-op self which was eating anything BUT normal).  I enjoy food and I wanted to continue to enjoy food  in all categories without fear of dumping.  Sure, if I over-indulge in white flour products or extra heavy on the carbs in general, I can get gassy - but that happened to me as a pre-op too so that is not a big deal to me.  I love knowing that I can have those products without fear of possible dumping...I haven't had gas that bad to be honest and it certainly doesn't peel paint off the walls as some would have you believe to be the case with the DS.

3.  Best long-term success rate at keeping the weight off.  Statistically the DS keeps the weight off better than other options.

4.  I'm a lightweight and still chose the DS even though some like to insinuate it's better suited for SMO with really high BMI's rather than Lightweights....this is just not the case.  IMO, if you qualify for WLS - then you should definitely consider the DS.

5.  A smaller, yet fully-functioning stomach, not a pouch. 

6.  I was tired of dieting.....and I knew with both RNY and LapBand I'd be dieting still....

7.  I visited the revision forum .....and I know me and I know in a coupla years, I'd have been on the reivision forum if I had gotten RNY or LapBand....

I know there are more but I think you get the idea.....

With all that said, you gotta know yourself....do your research (which you are) and pick what's best for you!  I also encourage you to visit each forum and ask questions about each procedure - and do visit the revision forum...

Good luck and happy researching!

Well I sure wish I chose the DS the first time, if only I had known about it. I did not research as you are diligently doing. I just followed my friend down the same path and had the RnY in April of '05. So after losing 90 pounds in 8 months, and then stalling for a year, going nowhere, then started the regain. I had regained 70 pounds. As I learned more about the DS, and found out about it when I was searching OH about a lapband over the RnY. WHEW! I am so very glad in searching for that, I found the DS forum, I JUST AM SO GLAD. Read the "revision" board, the "failed weight loss surgery" board and you will see so many seeking something better after the lapband or the RnY is no longer working for them. Don't be one of those statistics, get the DS the first time around. I love that i do not have to "diet" anymore, just be mindful of what I put in my mouth. I do enjoy carbs now and then, but I do know how to cut back and eat only protein, but still losing whatever I eat, and the inches are falling right off.

I wish you good luck in whatever you decide. The best place to find out what you need to know is at www.dsfacts.com, and, of course, coming to this forum and reading posts and checking responses. Certainly, check out the other forums while you are researching.
Karen

I had the DS because i didn' want to worry about weight regain. I am 4 years out next month and if you go to my months board (feb 06), there are already posts about people struggling to keep it off and a post about one woman *****gained all the weight she lost.

I do struggle with 10 lbs off an on.....but it's more about not eatting 2 boxes of oreos a day for me rather then dieting constantly like RNYers have to do.

Scott

I chose the DS because it has the best results of any wls - highest average amount excess weight loss, best maintainence of that weight loss, best resolution of comorbidities. It also has the most normal pattern of eating of any wls, with no foods off limits forever, you can drink liquids with meals, you can take NSAIDs, no dumping, no food getting stuck.
    I had encountered too many people, both irl and on the internet, with problems with inadequate weight loss or with significant weight regain with RNY. And lap band never sounded like a good option for me, as I had to eat 800 calories/day or less, at that point in my life, to lose weight at all. I needed something that would alter my metabolism, not just limit food intake. 
    It's great that you're researching the different options. So many people limit themselves to what they hear about in the media, or what their insurance prefers to cover, or what a surgeon who only does 1 or 2 operations tells them. Keep researching, and you'll figure out what's best for you.

Larra
   

Research the different procedures, and then come back and let me know if you find a single reason (other than severe GERD/reflux) to have the RNY when the DS is an option.