My endocrinologist discouraged the DS

Im also a band revision and like the other poster said, i dont want another pouch! And i have several people around me that have had RNY and only 1 of them has kept the weight off, 1 had some weight gain and the other 3 has had a lot of weight gain. Those odds are not good for me. Im young, i want children after the DS but i still plan to get the DS!

EVERY surgery has a chance for complications so 1 DSer having to be on TPN is ridiculous to even mention.

Yes longterm you may run into malnutrition but surgeries done 10+ yrs ago are often different that what is being done today so there is no saying as to what will happen. So in 10 yrs you can either get 3 iron infusions a year or starting going blind and having your toes removed one at a time because of diabetes...i think i would take the infusions:)

I wish you well in your choice and hope everything turns out great for you because lord knows after dealing with the band you deserve it!!

Oh really?  You think my 75cm cc is different from a 75cm cc that's done today with a DS?  How's that?

Does Dr. Gagner do the same 75cm cc, probably. BUT we have seen a trend with some surgeons that are refusing to due a common channel of less than 125cm with smaller stomachs. Is this the best way to do the DS? For some and im sure in another 10yrs more Drs. will be in the field doing what they think is the "prefect DS" 

Also, im thinking that your recent low levels of Vit A probably have more to due with your late in life pregnancy than the DS. Since pregnancy is hard on any woman i dont think you can only blame the DS only of any low levels you pull in the first year after birth, esp if you are breast feeding. Since, as you know, it can take a woman's body many months to return to normal. 

 

Nice theory,  but no.  I'm not breastfeeding.  And none of my other fat soluble vitamins are low - E, K, D.  My calcium and PTH are normal.    I'm anemic,  and my albumin is low.

I have fantastic,  and I mean fantastic,  physicians.  Hematologist,  endocrinologist,  internist,  gastroenterologist, ob/gyn.  Also am periodically in touch with a bariatric surgeon and a highly knowledgeable WLS nutritionist.

There is simply no reliable data out there on long term DSers.  And different people seem to respond differently over time.  My eating capacity,   for example,  is what is was pre-op.  Clearly the malabsorption is working for me very, very well.  Maybe too well these days,  given the A deficiency, the anemia, and the albumin deficiency.  I dropped the pregnancy weight in about 2 seconds.  I'm also a bit hypoglycemic ( have read plenty of other DSers who are too) so have to make sure to eat frequently and watch simple carbs for that reason too.

My point is that not only do things change over time,  but it is simply not possible to predict what any one DSer will experience over time.  Not only are there insufficient data,  but it can vary tremendously from individual to individual,  affected by age,  hormonal shifts,  etc etc

I am extremely pleased,  after all these years,  to have had the DS.  But it is not easy by any stretch of the imagination.  It is a lifelong serious thing,  very serious, and requires constant and permanent vigilance,  and preparation for and ability to deal with the things that may came up.  It is NOT for everyone.  Caveat emptor.

***LIKE***

I understand what you appear to be thinking about the trend in some surgeons toward smaller stomachs and longer common channels. However, do not make the error in logic of assuming that's better or less potentially dangerous than, say, those of us who have a Hess method intestinal configuration.

There's NO data to support that assumption. In 20 years we can be part of the data though :-).

You're also making an assumption when you say that the newer DS procedures are "often" done differently than they were 10+ years ago. Be careful there that you don't lull yourself with this thinking. Remember to look for the data to back up (or not) these assumptions.

Now, there IS data coming in about longer term RNY results and you're right, it looks pretty darned discouraging, at least from where we're all sitting. The researchers can't be loudmouthed like me and say THIS ****TY PROCEDURE HAS GOT TO GO AWAY. But some reading between the lines, as you probably already know, shows that there are a good number of minds out there in medical land that are getting disenchanted with the procedure.

Plus you have the experience of what you have seen with your own eyes. This is very helpful.

I don't want to presume to speak for NYB, but I'm not hearing her trying to talk you out of anything. I'm hearing the voice of experience, of which we have so very few here, saying, "HEY FOLKS **** CAN HAPPEN, so pull your heads out of fairy tale land and be REALISTIC."

I, too, would much prefer to get infusions or whatever over the hell that is dying of diabetes. As long as folks go in understanding that it CAN happen that way, it's all good.

That's why I am committed to always saying, when I talk about my success and how long it's been, to reminding people that my bottom line is, "So far, so good."

Sorry, OFTEN was the wrong word (should have been sometimes) and i realized it much later after i posted but that why we have peeps like you to keep us in line:) I know experience is VERY important but i didnt want her to shy away from the DS because of iron infusion, etc. Right now i really dont know **** about **** BUT i do try to keep myself educated:)

Thank EN, I think you are the best! 

Oh I agree. The specter of future issues is not a reason to ditch the DS in favor of another procedure IMO (well, except for the VSG in certain select cases). I just wanted to wave a small flag at you to make sure you were thinking carefully :-).

I sure hope AmandaDS sees your post. She's a longterm DS post-op who is herself a pediatric endocrinologist. And SHE chose the DS, and lives a very full and healthy life with it. (Amanda, if you see this, I hope you don't mind my mentioning you)
     It's hard not to be negative about some condition or procedure when a doctor has seen something seriously bad happen from it. We're all human, and that one example colors our perspective. But in reality the need for TPN may be temporary, and/or caused by the patient not being compliant, or caused by a complication - and complications do happen with the DS, as with any major surgery.  And if worst comes to worst and the patient needs a revision for excess weight loss or for nutritional issues, it's a whole lot easier to revise the DS for this issue than to revise RNY for a similar issue. But she's not a surgeon and won't know that.
       Perhaps your endo is unaware of the less than stellar results often seen with RNY, and the 30% failure rate associated with it. While it's easier to avoid nutritional problems with RNY (though rest assured they do happen), what is the point of having an operation with a high failure rate? Isn't failure, with resultant continued obesity and all the comorbidities associated with it, a complication? But I think the feeling is that since the medical community didn't "cause" that particular complication, they don't feel so bad about it.

Larra

Her argument is ridiculous. BECAUSE you are young and healhty is the perfect reason to get the DS. Get the weight off and KEEP it off and get rid of any comorbidities that you have, may have, or will have if you stay at your current weight. With the RNY you're going to lose the weight and then gain it back...you'll be back at square 1 with the same comorbidities and you may even gain a few new ones. Sure, with the RNY you MAY be one of the lucky ones who loses it all and can struggle hard enough to keep it off. You also MAY hit the lottery. I wouldn't start spending that cash just yet though.