DS or RNY - How did you decide?
The post-op DS 'diet' suited me---high in protein and fat, tolerant of a moderate amount of both complex and simple carbs. I felt it would be a LOT easier for me to do something, like take vites and supplements 4 times a day, than to not do something---namely, eat the foods I loved.
I needed to be able to take NSAIDs.
And---I needed the most effective surgery available to. My obesity was elephant-sized, so I wanted an elephant gun to deal with it. (*grin*) The RNY people talk constantly about working their tool. I felt I needed a tool that would do a lot of the work for me---kinda like the difference between a hand saw and a chairsaw.
6 of us at my old office had WLS. 1 band, 4 RNY, and 1 DS(me). We are all about 10 years postop now. I still look like a normal person and so does 1 of the RNY folks. The rest have gained back every pound and one of them still throws up at lease twice a week. The band person never lost much at all, maybe 20 lbs.
I'm thrilled I didn't just follow the crowd and have the RNY. Out of all these folks, I have the most normal life as well. I can still enjoy food without dire consequences. I made the right choice.
You need to make the right choice for you. You know you better than anyone else, including a doctor who sees you for 15 minutes. What will give you the postop life you want?
Most procedures have a honeymoon period where no matter what you do, you will lose weight. But long term is what you really need to look at.
Chris
HW/225 - 5'1" ~ SW/205/after surgery 215 ~ CW/145~ BMI-25.8~Normal BMI 132 ~DS Dr Rabkin 4/17/08
Plastics in Monterrey - See Group on OH Dr Sauceda Jan 13, 2011
LBL, BL, small thigh lift, arms & a full facelift on 1/17/11 UBL 1/21/13
Love my Body by Sauceda
For years I only knew about the RNY. At that time it wasn't an option for me because I still felt that if I were disciplined, I could lose the weight myself. I didn't yet understand that my body was working against me to maintain itself, even in an unhealthy state. I also didn't yet understand about WLS as a tool.
When I seriously began to consider WLS, I knew of RNY and studied it more, going to support groups, talking to long/short term patients and several doctors and I learned about the band. The band was not an option because my understanding from the surgeon was that it was for those with smaller amounts of weight to lose . . . you would be expected to lose 30-40% of excess at best. And I was really turned off by lurking on the message board and reading about PB's ("Productive Burps" which, I understood to be foaming regurgitation at any time while eating) as a common everday occurrence. At almost 500lbs, 40% was nothing, so I was back to the RNY. But the more I looked into it, it just didn't sit right with me for the following reasons:
1. The size of the "pouch" and the inherent risks of blockages due to the very nature of it.
2. The optimal weight loss for that procedure still would not do a great deal for me in comparison to the risk of surgery at my weight.
3. I was uncomfortable with the idea of closing off 98% of my stomach, but leaving it in as a failsafe in the event problems developed and it had to be reconnected. That's one he!! of a fail-safe. Plus, it would still create gastric juices with nothing to break down leading to ulcers, etc. and any issues with that section could only be addressed surgically as it is closed off. Nothing oral can get to it. I didn't like that. I felt like I was going to be a guaranteed, repeat patient to the surgeon for life just due to the nature of the procedure.
4. I didn't care for the "dumping syndrome" described to me by the surgeons. When I asked why it happened, they each hedged and just said to look at it as negative reinforcement to stay away from sweets and simple sugars. However, having spoken to quite a few RNYers, they described that what triggered dumping for them was arbitrary, not just sweets, candies or sugary drinks. For one broccoli did it, for another turkey, but not chicken did it. And some said even after several years they could not isolate specific foods that triggered their dumping, they just had to be prepared for it when it happened. I experienced a form of dumping early on after my gall-bladder removal and I did not care for it to be a normal part of my life.
Mind you, this is based on my understanding of what was shared with me at that time which is a good 8 years ago. There may be many for whom it is successful and who didn't experience any of what was described to me, but I had to make a decision based on my understanding of the procedure and life afterward. In a nutshell, the end result of the RNY in my mind was just too unnatural a mechanism for me to be comfortable with. So with that being my only option, I was not having any surgery, I'd just continue to try on my own . . . or die trying.
Then a friend of mine with much less weight than me to lose told me she had decided to have weight loss surgery. I was flabbergasted. I only saw her as slightly overweight, maybe 50-60 lbs to lose, nothing needing so drastic a step as surgical intervention. But I began researching again specifically to provide her with information and options. This was when I learned about the DS. As I began researching the DS, everything about it made sense. It countered all of my concerns about the RNY, infact . . . it seemed too good to be true. For example:
1. Normally functioning, but much smaller stomach retaining sphincter muscle at both ends.
2. Complete removal of the dissected stomach portion as there is no need for a fail-safe on that end.
3. No dumping as a negative reinforcement. I had already proven to myself that I could successfully eliminate carbs and sweets - so I didn't need that "tool", but I wanted the freedom of occasionally indulging as a normal person would.
4. Ideal for those with larger BMI's, hence more excess weight to lose.
Essentially, it leveled the playing field for me. My digestive system would function as normal with the exception of the major mal-absorption of the intestinal re-routing and I'd have to learn to adjust to that. But it still required learning good lifelong eating habits yet allowed me the freedom to occasionally falter without the world coming to an end . . . the ultimate loss, maintainance and health was still my personal, daily responsibility.
After much research, I prayed a great deal because as I said, it seemed to good to be true and I didn't want to make a foolish decision by only seeing what I wanted to see out of desparation simply because there was another option besides the RNY. But at every turn, I knew in my heart it was the right thing to do. To the point that, after my two-week pre-op freak, I was fine and in no way afraid approaching surgery. Finally, I can honestly look back, even when I've had not so great days or financial issues that I wouldn't have if I hadn't spent money on the DS (I was self-pay) . . . I can look back and say if I had to do it all over again, I would do it in a heart beat . . . so no regrets whatsoever. That's my story.
JoAnn
I appreciate so much the time you spent explaining how you came to the decision you did. I have to say that the more I hear, the more I am convinced that this is the right decision for me too. I feel really blessed to be able to receive feedback from folks like you who have already been there and done that and are willing to help newbie's like me as we navigate this process.
I am scheduled to go to a seminar on June 5th to meet the doctor I believe I will end up using for the surgery, Dr. Paul Kemmeter out of Grand Rapids, MI. My insurance company is mandated to offer WLS coverage, so I think things will move along fairly well for me. To say that I am excited is a big understatement, and I can't wait to be on the losers bench with all the rest of you!
Thanks Again!!