Did he describe the DS??

steff1970
on 5/4/12 8:11 am - cambridge , Canada
RNY on 07/09/12
 Hello everyone this is the very first time im  posting here but i really need someone who knows to help me out.....i met my surgeon this morning and he was talking to me about the RNY and VSG surgery but i currently am living with a colostomy so he is leaning towards the VSG which is ok with me however he seems to believe that i will only get down to about 225 pounds.....when he said that i just about fainted because i have seen other ppl with a VSG getting way below that and starting out heavier than myself but what he said next is what's got me totally confused.....he said when i get down to 225 pounds we will discuss reversing my colostomy and at that time because it will be open procedure he can possibly convert to the RNY, now if he does that will that mean i end up with a DS?....im sorry for sounding so ignorant i just never really researched much on DS because in Ontario its very difficult to get.....i hope someone can help me to understand this.



all the best 
Stephanie

 REFFERAL.....APRIL 2010    ORIENTATION.....JULY 14, 2011       SURGERY.....JULY 9, 2012                            

          122       

    
teachmid
on 5/4/12 9:10 am - OKC, OK
No. The RNY is totally different from the DS . There are some great graphics at Dr. keshishian's site, dssurgery
     -Gail-
SW  257    CW  169  GW  165
  
Chicarita
on 5/4/12 9:41 pm
 I don't really know what he's talking about. If you have a sleeve you therefore will not have the RNY pouch. He will have to do a DS configuration in the bowel. I don't think it would make sense to do RNY bowels, not even sure they can given the sleeve being in place and where they cut for the RNY.  

POI would research www.dsfacts.com and then ask a LOT of questions. 

Also, make sure your surgeon is on the VETTED doctor lists on that site. Imperative that he/she is. 
PatXYZ
on 5/5/12 2:57 am
The only qualified DS doc in Ontario isn't on the vetted list because he performs the DS exclusively within the public healthcare system (meaning, you can't pay to see him). His name is Dr. Dennis Hong, he's who the people in Ontario need to see.
larra
on 5/5/12 12:33 am - bay area, CA
Chicarita is part right and part wrong. She is right that once you have a VSG, it doesn't make sense to change your sleeve stomach to a RNY pouch. She is wrong, however, as to what your surgeon is talking about, because that's exactly what he's saying - he would take a perfectly good sleeve and change it into a pouch.
     The reason he would do something that doesn't make sense is that he doesn't do the DS. At all. In reality, once you have a sleeve, all you would need for the DS would be the "switch" part. Nothing further would need to be done to your stomach. But since he doesn't do the DS - at all - he is proposing the operation that he does do, even though it doesn't make sense.
    Sadly, he's not the only one. There are plenty of other surgeons out there recommending going from VSG to RNY for patients who don't lose enough weight with VSG.
     Getting back to your original question, RNY and DS are completely different surgeries. Head over to dsfacts.com for more research. I hope whatever you decide your surgery will be successful and that it will eventually lead to a reversal of your colostomy as well. And there is a thread (I haven't read it yet) on this page from someone else who apparently has been approved for the DS in Ontario so check that out and know all your options before you make any big decisions.

Larra
steff1970
on 5/5/12 2:48 am - cambridge , Canada
RNY on 07/09/12
 Thank you so much for your reply and i apologize again for being ignorant as i was so taken back from what my surgeon was saying that i really didn't absorb it well so....i called my centre and asked to have it explained again and he did a better job this time as well as letting me know that in the future he will perform "the switch" if  we both agree at time of colostomy reversal that it would be a good idea...i am so overwhelmed because i never even considered the DS because it's so hard to get approval however i am learning alot about the DS and i am pretty comfortable knowing that i just may be a candidate for it in the future.  thanks again all the best 

Stephanie

 REFFERAL.....APRIL 2010    ORIENTATION.....JULY 14, 2011       SURGERY.....JULY 9, 2012                            

          122       

    
PatXYZ
on 5/5/12 3:03 am
Please be extemely wary of Dr. Reed's claim that he can perform the 'switch' portion fo the surgery later. I've seen many people on the Ontario board being told this, but no one who has actually had it done. Also, it is not clear that when Dr. Reed says 'switch' that he is actually talking about a proper DS-style switch - I think it is entirely possible he is doing something more like a RNY bypass. Before consenting to this, confirm that he leaves the pyloric valve in place and ask him where in the duodenum he makes his incision, how long he makes the alimentary limb, how long he makes the common channel, who he learned the DS from, why he won't perform the entire procedure in one surgery, and how many has he performed in two parts to date?

Personally, the only person in Ontario I would let touch me if I wanted a DS is Dr. Hong. Please see my note below.
larra
on 5/5/12 3:20 am - bay area, CA
No apology needed! How were you to know that the surgeon would raise issues you weren't expecting? No doubt you were overwhelmed and needed a chance to absorb all the new info.
   
I agree with Pat, though, that we are now discussing a surgeon who, to our knowledge, has never done the DS, proposing that maybe somewhere down the line he'll do one (in 2 parts) for you. I've been on this forum about 7 years now, and never heard of this surgeon doing a DS under ANY cis****tances, let alone on someone like yourself who has had a lot of abdominal surgery already, and in conjunction with a colostomy reversal no less. I also value Pat's opinion, esp since she's in Ontario and knows the Ontario situation very well. I would be very wary about this plan.
     I think Pat's suggestion of a second opinion with Dr. Hong is a great suggestion. We know he really does do the DS, and given your bmi being near 50 to start with, you need the kind of metabolic changes that only the Ds will give you for longterm success. If, because of other medical issues, you need to have it done in 2 parts, so be it, but at least you would know for sure that you have a surgeon *****ally can and will do the DS.

Larra
PatXYZ
on 5/5/12 2:55 am
Hi steff1070, fellow Ontario person here!

You need to have a consult with Dr. Dennis Hong at St. Joe's Hamilton immediately. Dr. Hong is the only surgeon in all of Ontario who performs the DS and he can tell you the best way to proceed in your cir****tances. Doing a VSG and then converting it to a RNY is senseless butchery. Dr. Hong can tell you whether it is possible in your case to do a full DS in one surgery, or if he would recommend a VSG and then later conversion to the DS. There is no need and no reason to go from a VSG to RNY. Dr. Reed is only suggesting this as he is not capable of a DS. Please do not allow him to do this to you! I would rather have a VSG and have not lost all my excess weight than to have a RNY - there are far too many people with reactive hypoglycaemia, dumping, anemia and regain issues.

Please tell your assessment centre that you want a second opinion and ask that your file be sent to Dr. Dennis Hong at St. Joseph's Healthcare in Hamilton for consult. It will cause a delay between now and surgery but it will be worth it. Dr. Hong will discuss DS with you and why you want it versus VSG or RNY. Please read up on DSfacts.com extensively so you have a good understanding of the procedure and your responsibilities post-op in terms of vitamin, mineral and protein supplementation.

Please feel free to send me a PM. I had my DS with Dr. Hong on March 7th of this year.
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