Why don't dr's want to do the DS, and other Q's

Hello, I am new here and have been considering the DS. I went to my surgeons seminar last night. He rarely mentioned the DS as an option. during the Q+A session at the end I asked why, what his experience was and is it likely that he would do it. He said because it's an "extreme for of the gastric bypass and doesn't provide enough weight loss for the risks" (vitamin deficiancy and chronic diarrhea were the ones he mentioned.) He also said he does about 10 a year, and that GB was the "gold standard for wls". Just to give you some perspective he does 600 weight loss surgeries a year. I am slightly undecided between a distal rny and the DS. Distal RNY only because I feel that is an area of expertise for my surgeon and therefore safer perhaps? IDK, I am confused. I have 300lbs to lose and I'll be happy to get 250 off but I'm not sure that's possible with the rny. I'm terrified of going thru this just to end up at 300 lbs, I want to succeed in this but I know the type of "tool" I choose can be critical to that. Anyways I would love any input. I'm also curious what a day in the life of a DS'er is like pertaining to protein and supplements? I'm so glad I found this place thank you for your input!!!!!

He's only telling you that so he can get proper reimbursement from insurance. The DS takes longer to perform and the surgeon only collects as much as he would for an RNY or band.

We see vitamin deficiencies and chronic diarrhea in about .05% of the DSs performed. The vitamin deficiencies are many times, not always, due to patient non-compliance. Please find another DS surgeon from the list on www.dsfacts.com , or decide you're going to do your homework and go to your personal consult sticking to your guns about wanting the DS and nothing else.
 
I was a lightweight going into this and I follow Vitalady's vitamin plan...my surgeon trusts her too. I lost my weight and not too much, I have zero vitamin deficiencies and my labs are much much better now than they were when I was heavy, and I don't have diarrhea but go twice in the morning before work and that's it.

Your surgeon is trying to scare you away from a DS because he doesn't want to do it due to lost $$$. The ERNY will still have you dumping on sugar and fat, and likely developing reactive hypoglycemia at 3 years or so post-op. I would opt for the DS again in a heartbeat over any of the other surgeries. Granted I've never had any of the other surgeries but I've been on OH and a group with all surgery types for 5 years, and I've seen the results of the other surgeries--good and bad.

--gina

Hello Majormom, I just had my DS surgery in September. 2011.  I have lost about 80lbs to date, and have about another 90lbs more to lose to get to goal.  Although I am feeling so much better, I am looking for another Dr.  About a month after surgery I had a major complications.  Had a blood clot that burst and caused infection in my abdomen.  Had over 45lbs of infected fluid drained, I was in the hospital for almost 3 weeks.  I have totally lost confidence in my surgeon, I have only had 3 appointments since surgery and he is no longer on the list of surgeons for the hospital.  I have a great primary care doctor who has been great, but I thought my surgeon should be keeping track of my progress much closer.  Am I just being paranoid, or should I continue my search for another surgeon experienced with the DS surgery.  I have started having strange soreness around my incision and not sure what it is.  Have an appointment with my primary doctor next week.  Any insight would be appreciated.

fineatfifty

I think if I were in your shoes, I would look to switch DS surgeons for aftercare if my PCP wasn't willing to help. You may do just fine with only your PCP--many people do that. Do you know if there are any DS surgeons with hospital privileges at your local hospital?  There's a good list of DS surgeons on www.dsfacts.com if you need to shop for one.

--g
  

 I've never heard of your surgeon, so he must be new at doing the DS and you were a guinea pig, or he's a hack, which I hate to imagine.  Check dsfacts.com for the vetted surgeons, but Majormom is right - you may do fine with your PCP now if they're willing to help.

Well said "mom" !!

first you have to do what is best for you, not what your surgeon can offer you.  I was a revision to a DS, i went in with a bmi in the 30's.  I was switched in 2010, I have never had diarrhea, ever once (I mean unless I eat stupid stuff like simple carbs etc) most deficiencies can be managed by following a vit/min schedule.  there are no absolutes in medicine.  I would NEVER think of getting the distal RNY -your life would be completly miserable.  to have to lose 300 lbs?  that is an incredible amount of weight to lose, why not give yourself, your body the best chance at losing weight?  find a surgeon who does all weight loss surgeries, and not just a handful of some.  DS is not mainstream, there is so much ignorance surrounding it, and it is not as simple as the RNY.  you have to ask youself if RNY is the gold standard why so many RNY to DS revisions?  has there been a DS to RNY revision?  i have never heard of any.  i have never taken protein supplements, i just eat my protein.  keep asking questions,  i wish you the best in your journey.

 There is nothing much else to say because Majormom and airbender pretty much hit the nail on the head. I agree with all they have said.  

You have alot of weight to lose, the RNY wont do it... The distal RNY???? why would you even consider it when you can have the DS and a regular working stomach.  No dumping and no reactive hypoglycemia. The long term success rate is better then no other.  The distal RNY is for the failed / revised RNY's that have regained their weight.  The DS is so forgiving and works long term.  Not sure if you are diabetic, but 98% cure for type 2 diabetes.  

Many who have had the RNY regain, because they go back to their old eating habits and eat their way through their RNY.. If your insurance will cover hte DS, I suggesst highly you find a surgeon that will do the DS.  

I never have diarrhea....... well, learning if I eat Pastry from Whole foods I get a little. But nothing else makes me have diarrhea. I have never thrown up!!!!!!  My stools are more hard then soft.  

Life is great, cant stress that anymore. You are way tooo big for RNY.  

where in NY are you... Dr Greenbaum in NJ is a highly recommended surgeon.  There are also good one in NY city. Not sure of the name

Good luck
Donna

Thank you, I feel the same way. I think the RNY is for people with 100 lbs to lose. It's not that i think it's a bad surgery but it's not for the super obese. I'm in Rochester with VERY little means of traveling so far but I could make it work if I had to. I have alot of confidence in my surgeon, Dr. O'malley but is lack of understanding of the DS is making me think twice. He is an amazing surgeon, and his mortality rates are extremely good something like .1% and he is close. BUT that being said I will be making phone calls on Monday to see what my insurance will cover. Which unfortunalty in medicaid, and I'm not sure if they cover anywhere out of area. Thanks again.

Okay, I am a Lightweight DS'er...majormom and airbender covered everything...however, you look like you live in NY state if I am reading your profile correctly...

There are DS surgeon's in NY, mostly in NY metro. Roslin is on the dsfact list but Dr. Alfons Pomp, who did my husband's is also a very well qualified DS surgeon...He's at NYP/Weill Cornell and if you do talk to his office, ask for his assisitant, Kimberly Wu.

Liz