Well now I'm REALLY confused...to DS or not DS?
I don't think you're anti-DS. I also think that WLS has to be looked at by each person as an entire lifestyle change. My step-daughter is getting an R-n-Y this month. She is an RN and did tons of research besides seeing the results of me and my wife (both successful DSers) and listening to our concerns about R-n-Y. She decided that it was the best surgery for her lifestyle in the long term. I think she'll end up doing great!
Mike
HW 452/SW 428/ CW 188/GW 190
I agree absolutely with everything you say with one exception. I think that when a surgeon decides to become a bariatric surgeon (whether it's RNY or DS) and runs a bariatric practice, he thus becomes a bariatric practitioner, and at the very least, MUST set up a comprehensive post-op protocol for his patients. That may be limited to supplying required nutrition, supplementation and lab recommendations, and a statement that appropropriate hemos, endos, etc., might need to be seen. DS surgeons DO bear some of the responsibility of post-op nutritional deficiencies, because time and time again, I have read about (and have experienced) GROSSLY inadequate recommendations for post-op nutritional care. I was the first person in my surgeon's practice to jump up and down about 50 k iu's of dry D a day, previously, they wanted me on 400. 400! And they were wondering why my D was 8! I finally convinced them I wasn't going to keel over and die from vitamin D toxicity. When I had my DS, my surgeon didn't even order a PTH as part of my one-year labs, nor zinc, copper, or E. Now, with patients like me on their rears, they order appropriately. DS surgeons communicate with each other - my surgeon has been in touch with Gagner, Alveredy, etc. many times before, so they do know what works and what doesn't for most DS'ers. Many though, continue to treat patients like RNY'ers, and that's a crime. DS doctors have a tremendous responsibility to keep on top of current DS supplementation, just as I, as a teacher, have a responsibility to keep on top of current educational best practices. I do not expect my DS surgeons to follow my D issues, nor my iron. I see apppropriate specialists for that, and it is reasonable for any DS surgeon, if deficiencies persist, to refer out.
As to non-compliance and the fact that the DS is NOT for everybody (and I too get pissed off when people on these boards infer that it is) I agree with you completely. Just like marriage, one must not enter into the DS lightly. I feel strongly that extreme scrutiny of the DS patient must be made before a surgeon will agree to perform this surgery.
As to non-compliance and the fact that the DS is NOT for everybody (and I too get pissed off when people on these boards infer that it is) I agree with you completely. Just like marriage, one must not enter into the DS lightly. I feel strongly that extreme scrutiny of the DS patient must be made before a surgeon will agree to perform this surgery.
Julie R - Ludington, Michigan
Duodenal Switch 08/09/06 - Dr. Paul Kemmeter, Grand Rapids, Michigan
HW: 282 - 5'4"
SW: 268
GW: 135
CW: 125
Duodenal Switch 08/09/06 - Dr. Paul Kemmeter, Grand Rapids, Michigan
HW: 282 - 5'4"
SW: 268
GW: 135
CW: 125
What I find particularly egregious is that the surgeons purport to be doing adequate follow up care when in fact they are doing no such thing. Either they must really follow up and advise and manage the post-op issues , or they must refer out to other physicians who can/do that.
If a surgeon has no intention of truly maintaining a followup (bariatric) practice, that's fine, but dammit then say so and refer patients appropriately.
If a surgeon has no intention of truly maintaining a followup (bariatric) practice, that's fine, but dammit then say so and refer patients appropriately.
EXACTLY! Whether they are going to perform long-term post-op care, or require that their patients follow with a DS savvy internist needs to be clarified at the onset of acceptance as a surgical candidate.
Julie R - Ludington, Michigan
Duodenal Switch 08/09/06 - Dr. Paul Kemmeter, Grand Rapids, Michigan
HW: 282 - 5'4"
SW: 268
GW: 135
CW: 125
Duodenal Switch 08/09/06 - Dr. Paul Kemmeter, Grand Rapids, Michigan
HW: 282 - 5'4"
SW: 268
GW: 135
CW: 125
People die from the DS? Well I had my surgery with a BMI of 39 or 40 and landed under goal at 127lbs about a year later. I've gone on to have my third baby (surprise) and the day before I delivered weighed in at 205 (ya I gain a lot with pregnancy) and 7 months later sit at 165 -170lbs. I'd like to lose 15lbs which would have me wearing about size 6 but it's not the end of the world wearing a size 10-12 I guess. My Normie friends tell me to quit my *****in lol.
So, no, I'm no knocking on death's door 4.5 years later and haven't had any problems at all. Hope this helps a little.
So, no, I'm no knocking on death's door 4.5 years later and haven't had any problems at all. Hope this helps a little.
I've never met Dr. Crookes, but my impression is that if you get him away from that seminar you'll find him to be reasonable. Keep in mind that the seminar is a group event, that there are a wide range of levels of knowledge, intelligence and dedication in that group, etc. If/when you see him, he'll want to make sure you know what you're getting into with the DS. I don't see any harm in that. But once he sees that you've done your research and understand the requirements for maintaining your health with the DS, he'll do it.
Keep trying to get in with Dr. Keshishian, though. And I think when you do, you will hear a very different point of view.
And least anyone forget, you can get into plenty of trouble with RNY by not following the vitamin and supplement rules, it just might take a bit longer.
Larra
Keep trying to get in with Dr. Keshishian, though. And I think when you do, you will hear a very different point of view.
And least anyone forget, you can get into plenty of trouble with RNY by not following the vitamin and supplement rules, it just might take a bit longer.
Larra
Howdy,
I had surgery with Dr. Crookes and my BMI was 39. He had me explain the DS to him and made sure that I understood what I was doing. So, yes he wants to know that you are committed to the process.
His office and the information that he provides is geared toward RNY, inmy opinion. So, it would not surprise me that some patients could follow the medical guidance given to them and still have problems down the line.
There are horror stories for every WLS procedure. There are also successes for each. I am very glad that I choose the DS.
Even though Dr. Crookes will do whichever surgery you ultimately desire, I think Dr. K is better for DS patients for a variety reasons.
I had surgery with Dr. Crookes and my BMI was 39. He had me explain the DS to him and made sure that I understood what I was doing. So, yes he wants to know that you are committed to the process.
His office and the information that he provides is geared toward RNY, inmy opinion. So, it would not surprise me that some patients could follow the medical guidance given to them and still have problems down the line.
There are horror stories for every WLS procedure. There are also successes for each. I am very glad that I choose the DS.
Even though Dr. Crookes will do whichever surgery you ultimately desire, I think Dr. K is better for DS patients for a variety reasons.