RNY vs DS
Needing facts and opinions... I started looking into having wls several months ago. I have done all pre-op requirements of my surgeon.
At my first consultation with the surgeon, we discussed the different wls options and I explained to him that I am interested in the RNY, mostly because my mother and sister have both had it done with great results and are a great source of "been there" support.
Due to my BMI being 52, he told me to consider the DS as we had plenty of time to decide because of its higher success rate with comorbidites and long term weight loss.
Since then I have done all my pre-op with the RNY in mind, including my nutrition classes and pre and post op nutrition requirements and diets. Not to mention following this board for RNY, reading online and books about the RNY, and mentally preparing for that surgery.
I received a call from the surgeons office stating that I had been approved for the DS... they had sent it to insurance for the DS, not the RNY. I explained this to the nurse that called, and she said it would have to be resubmitted. A few minutes later, she called back and said the surgeon wants to consult with me next week to talk about my options before it is sent back to insurance.
I have a feeling he will want to talk me into the DS, and I don't know what I need to say to him to let him know the RNY is for me. Does anyone have a good pro/con list that would be of help or anything like that?
He is the only local bariatric surgeon so I am commited to him doing the surgery.
Any advice?
At my first consultation with the surgeon, we discussed the different wls options and I explained to him that I am interested in the RNY, mostly because my mother and sister have both had it done with great results and are a great source of "been there" support.
Due to my BMI being 52, he told me to consider the DS as we had plenty of time to decide because of its higher success rate with comorbidites and long term weight loss.
Since then I have done all my pre-op with the RNY in mind, including my nutrition classes and pre and post op nutrition requirements and diets. Not to mention following this board for RNY, reading online and books about the RNY, and mentally preparing for that surgery.
I received a call from the surgeons office stating that I had been approved for the DS... they had sent it to insurance for the DS, not the RNY. I explained this to the nurse that called, and she said it would have to be resubmitted. A few minutes later, she called back and said the surgeon wants to consult with me next week to talk about my options before it is sent back to insurance.
I have a feeling he will want to talk me into the DS, and I don't know what I need to say to him to let him know the RNY is for me. Does anyone have a good pro/con list that would be of help or anything like that?
He is the only local bariatric surgeon so I am commited to him doing the surgery.
Any advice?
Before deciding against the DS...go to DS facts and read.
Also read the revision and regrets boards.
As to being committed to your local surgeon...that is poppy****would you only buy a Ford if that was the only dealer in town? What if you wanted a Chevy and not a Ford?
While most surgeons would prefer the RNY, it sounds as if yours is on board...so keeping him sounds like a good idea.
I chose the DS for several reasons, esp the need to take NSAIDS. I did NOT want a surgery that prevented that option.
Also a study sent to the endo's (NOT bariatric surgeons) stated that diabetes makes a comeback even after WLS (they were talking about the RNY); health.yahoo.net/news/s/hsn/diabetes-can-make-a-comeback-aft er-weight-loss-surgery-study
Please do not rule out the DS until you have done the research. Then make up your mind.
Liz
Also read the revision and regrets boards.
As to being committed to your local surgeon...that is poppy****would you only buy a Ford if that was the only dealer in town? What if you wanted a Chevy and not a Ford?
While most surgeons would prefer the RNY, it sounds as if yours is on board...so keeping him sounds like a good idea.
I chose the DS for several reasons, esp the need to take NSAIDS. I did NOT want a surgery that prevented that option.
Also a study sent to the endo's (NOT bariatric surgeons) stated that diabetes makes a comeback even after WLS (they were talking about the RNY); health.yahoo.net/news/s/hsn/diabetes-can-make-a-comeback-aft er-weight-loss-surgery-study
Please do not rule out the DS until you have done the research. Then make up your mind.
Liz
Duodenal Switch (Lap) 01-24-11 | Surgeon: Stephen Boyce | High weight: 250 in 2002 | Surgery weight: 203 | Lowest weight: 121 | Current weight: 135 | Goal weight: 135
http://www.obesityhelp.com/forums/any_wls_regrets/
http://www.obesityhelp.com/forums/complications/
http://www.obesityhelp.com/forums/failed_wls_second_time_aro und/
http://www.obesityhelp.com/forums/revision/a,messageboard/bo ard_id,5360/
http://www.obesityhelp.com/forums/complications/
http://www.obesityhelp.com/forums/failed_wls_second_time_aro und/
http://www.obesityhelp.com/forums/revision/a,messageboard/bo ard_id,5360/
Valerie
DS 2005
There is room on this earth for all of God's creatures..
next to the mashed potatoes
Thanks, Valerie...I was just coming in to link those and you were nice enough to do it for me. :)
Liz
Liz
Duodenal Switch (Lap) 01-24-11 | Surgeon: Stephen Boyce | High weight: 250 in 2002 | Surgery weight: 203 | Lowest weight: 121 | Current weight: 135 | Goal weight: 135
Hi,
If you are going to consider the DS, I would go to Dr. Inman in Carmel. Otherwise, hold your ground with your doc. I too live in Indiana and I've never heard this dr's name as being a well vetted ds surgeon in our state. He may be trying to get into the DS biz, but I wouldn't want to be a patient of a new DS surgeon.
I know you are leaning toward the RNY, but I would strongly recommend you take a serious look at the DS. Patients who have BMI's greater than 50 usually have better long term results with the DS versus the RNY. However, I do get what you mean about having the support of others around you who have already had the surgery and have been successful.
If you are going to consider the DS, I would go to Dr. Inman in Carmel. Otherwise, hold your ground with your doc. I too live in Indiana and I've never heard this dr's name as being a well vetted ds surgeon in our state. He may be trying to get into the DS biz, but I wouldn't want to be a patient of a new DS surgeon.
I know you are leaning toward the RNY, but I would strongly recommend you take a serious look at the DS. Patients who have BMI's greater than 50 usually have better long term results with the DS versus the RNY. However, I do get what you mean about having the support of others around you who have already had the surgery and have been successful.
So many people try so hard to get the DS and have to fight their insurance companies. I am a DS'er heart and soul. I love to eat my fats, protein and be able to have the occasional treat that would send RNY'ers into hypoglycemia. I do not have to exercise my life away, at this time. I would never trade my DS for anything. If you don't want the DS then don't have it. Not sure why you feel the RNY would be better for you. Can you enlighten me on that? Is there some sort of fear you have of it?
SW 1012/11 265# CW 10/10 142#
Unlike some of the other people here, I have heard of your surgeon doing the DS. HIs patients seem to be very pleased with him. That's all I know about him.
As to why he feels it's a better option for you, there is only one study in the medical literature that studied matched groups of people with bmi over 50 having either DS or RNY during the same time period with the same surgeons. The complication rate was the same for either procedure, but the DS patients lost more weight. As time went on, the difference only became greater.
Since that study was published, the authors have presented date (not published as far as I know) regarding resolution of comorbidities in what certainly sounds like the same groups of patients. And guess what - again, the DS patients did much better in resolution of major comorbidities such as type 2 diabetes, high blood pressure, and sleep apnea. This comes as no surprise, as the superior results of the DS for resolution of almost all comorbidities has been seen every time this question has been looked at.
So while I understand that you had a mindset of RNY and you have seen your family members do well with RNY, your surgeon is actually looking at this in terms of evidence based medicine. And do keep in mind also that the failure rate for RNY is 30% long term, and higher for people with bmi over 50. And your relatives (whom I wish nothing but success) are not longterm post-ops yet. We don't know what the future holds for them.
If, after reading more about the ds, you still want RNY, that is what you need to tell your surgeon. He can't do ANY procedure without your consent. But I really think you have an incredible opportunity here to do better, and hope you can step back and look at both procedures with an open mind.
Larra
As to why he feels it's a better option for you, there is only one study in the medical literature that studied matched groups of people with bmi over 50 having either DS or RNY during the same time period with the same surgeons. The complication rate was the same for either procedure, but the DS patients lost more weight. As time went on, the difference only became greater.
Since that study was published, the authors have presented date (not published as far as I know) regarding resolution of comorbidities in what certainly sounds like the same groups of patients. And guess what - again, the DS patients did much better in resolution of major comorbidities such as type 2 diabetes, high blood pressure, and sleep apnea. This comes as no surprise, as the superior results of the DS for resolution of almost all comorbidities has been seen every time this question has been looked at.
So while I understand that you had a mindset of RNY and you have seen your family members do well with RNY, your surgeon is actually looking at this in terms of evidence based medicine. And do keep in mind also that the failure rate for RNY is 30% long term, and higher for people with bmi over 50. And your relatives (whom I wish nothing but success) are not longterm post-ops yet. We don't know what the future holds for them.
If, after reading more about the ds, you still want RNY, that is what you need to tell your surgeon. He can't do ANY procedure without your consent. But I really think you have an incredible opportunity here to do better, and hope you can step back and look at both procedures with an open mind.
Larra
I really can't understand why anyone would want RNY instead of DS. The DS has the best long-term stats for people with BMIs over 50. The DS has the best stats for long-term weight loss. The DS allows the best post-op diet. The DS cures diabetes and it never comes back, whereas with RNY the diabetes comes back about half the time. I think you are incredibly lucky to have a surgeon who understand that the DS is the best surgery for you.
RNY is unlikely to help you to lose all your excess weight, the 5 year average is just 65% of your excess weight lost, is that enough for you? The malabsorption with RNY goes away, whereas it is permanent with the DS which helps you to keep the weight off in the long-run. The RNY is likely to cause you both anemia and hypoglycaemia, are you prepared to deal with those complications which happen to a majority of women with the RNY?
Read up on www.dsfacts.com to understand the post-op nutritional and supplement needs of a DSer.
RNY is unlikely to help you to lose all your excess weight, the 5 year average is just 65% of your excess weight lost, is that enough for you? The malabsorption with RNY goes away, whereas it is permanent with the DS which helps you to keep the weight off in the long-run. The RNY is likely to cause you both anemia and hypoglycaemia, are you prepared to deal with those complications which happen to a majority of women with the RNY?
Read up on www.dsfacts.com to understand the post-op nutritional and supplement needs of a DSer.
I had OHIP approved Duodenal Switch surgery with Dr. Dennis Hong at St. Joseph's Hamilton on March 7th, 2012. Want more information on the DS in Ontario? Send me a private message!
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