Stuff y'all probably answer all the time

"I live in a household full of men and my gas is now legendary!"

THIS is the funniest thing I've read all week.  Thank you for that!

 See gas isn't that bad!!! It's good for a laugh. But it can be troublesome at times but as you learn what your new body can handle or not, you learn quick unless you are like me and like to push the envelope ... repeatedly. Gas-X does seem to help me, but I very rarely take it.
Good Luck!!!

Hey, it's my fellow DAO fangirl!  I'm glad you are researching your options.

The gas is largely a YMMV thing. Mine has not been any worse than pre-op, and now that I'm taking a probiotic, I think it might actually be better. I think I have been particularly lucky in this regard, though. FWIW, RNYers can get paint-peeling gas too. It's a feature of any malabsorptive procedure.

My DS was done lap and took 6 hours (I had a huge liver and spleen, I also had appendectomy and liver biopsy done at that time). I was only in the hospital 2 days, and my recovery was relatively easy - no real complications.

Now here's my copy/paste that I usually bring out when this topic comes up.

Below are the main reasons I chose DS over RNY:

1. The DS has the 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%

The regain or insufficient loss down the road with RNY was really troubling to me, especially with a starting BMI over 50. Studies have shown that RNY has a 40% failure rate at that BMI (meaning 40% don't even lose 50% of EW).I know the bad luck I've had with diets, etc in the past. I wanted the odds of success in my favor as much as possible 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 gamble 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 issue down the road.

4. No dumping syndrome. Dumping sounds horrible to me, and I didn't want to chance that experience. I've also known post-RNY folks who dump on unexpected foods (not just sugar but fat). I wanted to be able to enjoy a variety of food post-op, including sweets. 

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 (i.e. being able to drink with meals, no worries about stoma stretching).

I hope this helps! Please stick around, do lots of reading, and let us know if you have questions.

Jenna

 FWIW, RNYers can get paint-peeling gas too. It's a feature of any malabsorptive procedure. 


This is such a good point, and I always forget to include it. I like how we get saddled with the largest chunk of bathroom issues, when I see just as many (if not more cause no one tells them it could be a problem) threads on the main board from RNY patients with gas or dhr problems. I should start saving links in notepad so I can just mass paste them one day the next time someone asks.

P.S. - Definitely check out www.dsfacts.com/. A lot of great info there.

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 over three years, and so far, so good :-).

 

You've been given some great information and resources. I just wanted to add to your last question....

What resources did you use to make the decision to DS instead of RNY?

I lived on these Boards and I read as many posts as I could. I also was advised to spend some time on the Revision Board and I did and read the posts there as well. It became very obvious which surgeries were most likely to fail and the DS was not one of them. I knew I had one shot at Weight Loss Surgery because I was self-paying. I wanted the the best surgery the first time, so I chose the DS. Best decision I've ever made!

I'm a pre-op and wanted to say welcome to the boards.

Also, www.DSFacts.com is a great site.

I chose the DS because the diet allowed more flexibility than the others. I also liked that there was no dumping and that there was no blind stomach like Shan said (that scared me). I also kept hearing from family and friends about so many people who have had Gastric Bypass and have either gained all the weight back and/or had problems with it.

 Hey BLR!  I am going to be having the DS with Dr Sudan.  I think it was good that he lead the seminar.  The nurse who lead the one I went to wouldn't spend more than 20 seconds on the DS and told everyone there to expect 6-8 BMs a day. WTF? If I hadn't been armed with the truth I would have nixed that option right then and there. The whole room gasped in disgust, so sad cause so many there that could have benefitted from DS info.   Dr Sudan does both surgeries so request him personally if you like him.  If you don't, Duke will assign you a Dr.  

I do know that the DS takes longer to perform than RNY.  Dr Sudan uses the lap DaVinci robot for precision.  In fact he helped pioneer the use of the robotics in bariatric surgery.  

It's funny you mention it - Dr Sudan is the one who was telling us about the DS leading to horrible gas, etc.  So it's not just the nurses - it's him, too!  He hardly spent any time on it in the meeting aside from pointing out the variance in vitamin malabsorbtion (Iron and Calcium are okay and it's... what? D & A that don't absorb well?). 

You may find this funny too - I called the main line and the woman who answered the phone had no idea what a Duodenal Switch was.  Of course, I'm not sure she recognized the term RNY, either.  I may very well be switching to Dr. Sudan.  When is your surgery?