Stuff y'all probably answer all the time

 I have been by the phone for the last 24 hours waiting for them to return my phone call.  Sometimes they're good about it, sometimes not.  Dr Sudan told me that the DS at that clinic is still new (he 's been doing the DS for years in Nebraska) so the staff don't really know a lot about it yet.  With 5-6 surgeons there, the place is like an RNY mill IMO.

Overall, I think the purpose IS to scare people a bit.  It's a serious surgery and yes, things can go wrong... extreme diarrhea could happen.  But there are fixes to those severe problems that a small minority might experience.  Dr Sudan's Fellow warned me that I might become emaciated. I just smiled and nodded.  I'm always thinking.... is this a test? lol

I am still preop, at least for another week and a half (yay!) but I will share what I know.

I think Dr. Sudan is the Duke Dr. and there are quite a few of his patients on here so I am sure they can chime in on him.

The vitamins RNYers and DSers malabsorb are the same ones, ADEK. The difference is that the RNY fat malabsorption benefits seem to go away within 2 years yet they still need to supplement with vitamins forever, the DSers malabsorb a lot more and maintain most of that malabsorption forever.

Of course the malabsorption also puts us at higher risk for things like protein malnutrition, osteoporosis and vitamin deficiencies etc. so its REALLY important as a DSer to stay on top of things like protein intake and vitamins.

As far as the gas goes, from everything I have ever read, it seems to be controlled by diet. A lower carb, higher fat and protein diet doesn't cause the horrible gas. A diet that is very high in simple carbs and sugars will cause some nasty gas problems with quite a few DSers but again, not all. Also, most DSers seem to know that if they want to eat these foods, they just make sure they aren't going to be around a lot of people when the gas kicks up. So no pasta on a first date unless you are planning on going home right after. My surgeon also believes that a lot of the gas problems have to do with the common channel length. He tends to lean more on the conservative side with a 125 cm common channel and claims that his patients have fewer food intolerance's and bathroom issues and the difference in weight loss between a 100cm cc and a 125cm cc is insignificant. I am not too sure about that just yet since I am still pre op and I have seen patients of his just drop weight like its nothing with a 125cc and some are slower losers. Every patient of his that I have spoken to so far seems to have very few bathroom/gas issues and no major food intolerance's so maybe he is on to something.

My DS is hopefully going to be done lap unless there is some horrible complication and he needs to switch to open. My surgeon says he does RNY in about 2 hours and DS in about 3. The DS is a more complicated surgical procedure and there are very slight (.5%?) increased risks with it but there are many very skilled surgeons out there who have incredible track records. Both RNY and DS are complex surgical procedures, so I would rather do things right the first time.

As for post op complications, there can be many including strictures and bowel obstructions but from my understanding the complication risk is about the same. DSers do not dump because we have a pyloric valve, we do not have pouches or blind stomachs. We can drink and eat with our meals once we are a little further out. We have a perfectly functioning normal stomach, its just much smaller. We are able to eat normal sized meals after a while, which is beneficial in social situations.

Why DS over RNY for me? Really, after reading about the 2 procedures there was no doubt in my mind that I wanted a DS. It was a DS or VSG for me and since I want to lose about 165 pounds the DS is not only going to be the best way for me to lose it but to maintain that loss 10 years down the line. I mean really, not to sound snarky but other than helping with some GERD issues, in what way is RNY a better procedure? Wow, and I didn't even get my ***** chip implant yet. btw... the ***** chip is included in the surgery.

Seriously speaking... no pouches, no dumping, no blind stomach, the ability to take nsaids, no ghrelin, *real* malabsorption for life, better co-morbidity cure rate, ability to eat normal sized meals, ability to eat a high fat diet, similar risk and complication rate, same vitamin regimen, better weight loss and maintenance statistic. For me, there really is no contest. I have lost weight to goal or around there multiple times in my life and struggled to maintain that loss. It isn't the dieting and weight loss portion I struggle with, its regain and the requirement to stick to 600 calories a day and exercise like crazy to maintain that. I am getting a DS so I won't have to do that. I am getting a DS because I am done with dieting.

I don't think people that get RNY are stupid or evil or wrong or anything else. There are many reasons why someone would get a RNY. It isn't like RNY is a bad surgery and many don't have access to a DS surgeon, many can't afford to pay out of pocket, many can't get insurance approval and don't want to fight it or deal with the hassle. As someone on the RNY forum said the other day... I'll get the RNY now and if 10 years down the line I am struggling with it, I'll consider the DS. For me, I would rather do things right the first time and not take any chances.

My surgeon also thinks that RNY and the lapband will be phased out for DS and VSG in the future. Who knows.

Good luck to you with whatever you decide.

Also... I read this on the forum and it was written by someone named Lola to show perspective between the DS mindset and the RNY mindset. I am not sure if she was a revision or not but I found it to be very poignant.

Why I chose the DS over Rny.

RNY - I got the  surgery so I'd dump  and the fear of that would keep me  away from sugar.
DS - I got the  surgery so that I  wouldn't dump.

RNY - I needed the  restriction to  correct my  relationship with  food.
DS - I didn't want  the  restriction  because I want to  enjoy my relationship with  food.

RNY - I wanted/needed to change my eating habits.
DS - I've dieted my whole life -- I want to quit dieting.

RNY - I'm sick of dieting and failing.
DS - I'm sick of dieting and failing.

RNY - I want a tool that I can work.
DS - I want a surgery that does the work.

RNY - I didn't want to be able to cheat the surgery.
DS - I want to be able to 'cheat' from time to time.

RNY - I want to be healthy.
DS - I want to be healthy.

RNY - I didn't want someone cutting off my stomach.
DS - I don't want a blind stomach.

RNY - I don't want to have to eat massive amounts of food.
DS - I want to be able to eat what I want.

RNY - I needed to change my habits.
DS - I've been trying to change my habits my whole life!

RNY - I never want to eat sugar or fat again!
DS - I don't want sugar and fat to be 'off-limits'.

RNY -- I want the convenience of a close by surgeon.
DS -- I want the convenience of a one-time surgery.

RNY - My insurance would only pay for the RNY.
DS - I fought my insurance long and hard for what I wanted.

RNY - I need to not eat fat because of my high cholesterol.
DS - I need to not absorb fat because of my high cholesterol.

RNY - I didn't want to risk that much malabsorption.
DS - Based on my own diet history, I knew that I needed the added malabsorption to keep off the weight.

RNY - I need help to lose weight.
DS - I'm great at losing weight, what I need is help to keep it off.

RNY:  I know what's best for ME.
DS:  I've seen the revision board, and people don't always choose what's best the first time.

RNY:  Published, peer-reviewed studies are rhetoric.
DS:  I based my decision on statistics from published, peer-reviewed studies.

RNY:  You can't know anything about a surgery unless you have had that surgery.
DS:  I can know the likely results and complications of a surgery even if I'm pre-op because I did my research.

RNY:  There's no need to put down other types of WLS.
DS:  Statistically the DS is best and comparing and contrasting with the other surgery types is the only way to promote it effectively.
 

The gas can be smelly, but then who has pleasant farts?  More often than not, this is regulated by what is eaten. Knowing the trigger foods really helps one to eliminate them or at least time when best to enjoy them. I have yet to experience constipation. I'm so regular it a bit ridiculous!

My DS at Duke was done lap. I can't tell you how long it took, but my huge liver did cause it to be more difficult than expected. Dr. Sudan is an excellent surgeon. He won't set a goal weight for you unless you press him to though. I personally don't have one.

The main reasons I chose the DS include usage of NSAIDS (I have lupus), keeping a fully functioning tummy, being able to eat like a normal non-wls person, success rate of the DS, and ease of compliance (protein first...) for me (love me some meat!).

I used a variety of resources, such as speaking with Dr. Sudan, websites, published research articles, DS yahoo groups, and asking questions on OH. Research, research, research.


HTH,

Renee

You've gotten some excellent information here. Not much I can add, except that I love my DS and am forever grateful that I found out about this procedure BEFORE I had the RNY. I've watched too many family & friends regain and struggle with dumping, vomiting, stoma issues, etc.

I also wanted to say welcome to our forum - read lots, the vets here are very, very knowledgeable, and we'll go out of our way to help those *****ally want this surgery AND are willing to listen!

ETA - One more wonderful thing about the DS - I am reading this post while eating breakfast. I am three months out and I'm enjoying a fried egg and maple sausage patty. If I have room after that, I will have a piece of whole-wheat toast with a lot of butter. I have been eating like that for three months and have lost almost 90 lbs. Did I mention I love my DS?

Hey BLR,

I'm in NC too but I opted to go to Dayton OH with Dr. John Maguire; not only because he's a vetted kick-ass DS surgeon but because my entire family is from Dayton and I'd have oodles of support. At the time of my DS, Dr. Sudan was just getting set up at Duke and from what I remember from posts on OH, he was great but his office staff sucked. Hopefully things have settled and they are running at optimum.
 
I had my DS open, which was not a big issue with me. Constipation after the DS does occur and can be alleviated by increasing your fat, fiber and/or fluid intake. Some people though even that doesn't help.  DS'ers gas is pretty controllable by what they eat. I can tell you my DH's gas can rival any DS'ers, including mine. Yep, flowers wilt and cats hide when my DH lets 'em rip. Resources I used to make my decision were the usual peer review data, stats, etc. Also I knew I couldn't live with a RNY...I wanted to be a 'normal' eater, not punished for wanting to be so. I knew without a doubt my decision was a perfect fit for what I expected wls to be and at this point I can honestly tell you I wasn't wrong.

 lol My husband has subjected me to years of the ole "Dutch Oven" farts.  I told him I was gonna have my revenge soon.  

Thank you to everyone for your very thoughtful responses. I'm really leaning towards DS at the time, but without the procedure code, I have no idea if it will be covered by my insurance. I've left a message at the clinic to see if they can help me out with this.

Thank you!!!

Funny, with all the great reasons listed above there was one factor not mentioned that tipped the scales for me.

When I first came on these boards I was enroute to an RNY. I read the boards. Funny...
The RNY boards had a majority of the posts saying "how do I deal with xxxxxx?"
The DS board had a majority of the posts saying "WOW I love my DS"

Despite what people say on any of the boards, there are tons of successful patients from each of the surgeries....even the band. That does not mean however that anyone can do well on any of the surgerys. You have to see which fits your lifestyle better. Can you commit to lots of vitamins on time, and the cost For the DS? For the RNY can you live your life eating 1000 calories a day? With the band will your insurance cover your future revision to RNY or DS?

The CPT code for the DS is 43845.