RNY VS.DS?

D alot of the same rules apply betweend DS RS' nd RNY RS'??? What about this no drinking and eating at the same time??

No, very different. You have to take supplements with both, and you can get gas from certain foods with either, but other than that, whit the DS you don't have all the food restrictions and issues like dumping, stoma getting stretched or restricted, the remnant stomach issues, foamys, sliming, stuck foods, inability to drink with meals or take NSAISDs for pain. We eat more protein after WLS, and because we are able to eat a more varied diet and don't have to restrict fat, it makes it much easier to get protein from many sources. Our diets are more like a normal thin person. Smaller meals, with no weird restrictions. After you lose the extra weight, you can also partake in treats like birthday cake or seasonal goodies in moderation.

The DS has the best results for getting the excess weight off, and maintaining that loss. It also has the best resolution of co-morbidity's including up to a 98% cure rate (not remission as with RNY or band, but actual cure) of type 2 diabetes. Most DS folks have enviable cholesterol levels, because we don't absorb some fat.

There are links to peer reviewed medical studies and other good info at DSfacts.com. It's smart to do your research first, so you only have to get cut once. The revisions board is another eye opener. There are many band and RNY folks there looking to revise to other surgeries, but never a DS wanting a band or RNY. Do your research before selecting a surgeon.

Preface: It's clearly a touchy topic, so my intent is in NO WAY to start yet another DS vs. RNY heated debate.  Let's be civil!

Edited to fix a typo!  I HATE the your/you're mix up but I still do it, albeit rarely, if I get going too fast!! I also turned the links into actual links :)

The above post is really good about pointing out the benefits of DS over RNY, and so I definitely encourage you to take what she said to heart.  I also in no way want to say one is "THE better" choice, because only you know what's right for you.

I struggled with whether or not to pursue the DS since my BMI began so high- a 58.9.  My surgeon is nationally renowned and he studied under a man considered to be the best weight loss surgeon in the country.  That said, my surgeon doesn't do DS.  Every year he battles with whether he should but then when he reconsiders it he decides not to start.  There are a few reasons, but rather than speaking for him, I'll speak for me and why I decided against it.

First off, it's an extreme surgery and it requires very close follow up with the surgeon for the rest of your life, even more so than a distal RNY (which I am having).  The problems with malnutrition and DS can be much more severe due to the drastic changes in your innards.  

To compare, here are links to two pictures of what is done with a DS and an RNY:

http://meltingmama.typepad.com/photos/uncategorized/2007/11/11/dsdrawing4.jpg

http://www.dfwbariatric.com/files/site_images/Distal_RNY.png

(as an FYI, our small intestines are about 20 feet long, so those are obviously simplified diagrams!)

For me, the main reason I am having this surgery is to live, to no longer have my life in danger of ending abruptly and at a young age.  The second reason, running a close second, is so that I can have babies.  I'm only 27 and want to have a large family and WLS will help with that; I know that you can have a baby after DS but it's just that much harder than with RNY.

Also, in vein with the nutrition thing, my surgeon- who is classy, top notch, and beloved by the nearly one thousand people he has operated on, and whom my husband and I trust (and that's saying a lot becasue my husband is VERY slow to trust people but Dr. Chebli has his utmost respect!)- said that the DS is so drastic and requires such close follow-up that there are only two surgeons in the entire country whom he would recommend to me, and they are located in the DC area (the one he studied under) and another in Miami.  I forget their names, but he knew them by name and at the time when I looked them up (it's been almost 10 months) he was right- they are the best.  My husband and I just weren't comfortable with the DS for that reason- I can't afford to fly to DC or Miami so often, and Dr. Chelbli is so good at RNY- his numbers actually rival DS numbers as far as weight lost / maintained off- that we chose to put me in his hands.

Next, a big problem for me with DS is that, as my surgeon told me, often DS'ers can make poor food choices but still lose weight / keep weight off because "the surgery wins".  Again, it's so drastic that your body just can't keep up.  With this, having the larger stomach instead of the small pouch doesn't require as much careful consideration of portion sizes, so that in addition to being able to eat less healthy foods (namely, those high in either sugar, fat, or empty carbs) yet still able to lose weight is not appealing to me. 

I know myself, and while I don't assume all DS'ers do this, I know that I would think, "Well, I can eat that hamburger and piece of cake because my body couldn't absorb it if it wanted to!".  I'd basically bend the rules to be able to keep worshiping food and finding my joy in it.  The RNY is more likely to limit me, both because of the smaller pouch and the fact that I'll likely dump on bad food choices and just the fact that I might means I'll stay away and not test it.

The last thing is that DS'ers tend to have really bad issues with gas and loose, smelly, icky  stools for the rest of their lives.  While RNY has some of that, my research found time and time again that it's much more amplified with DS.  

All of these things, for me, outweighed the positives of DS (as shared in the previous post).  I am not saying one is better for you, but it's good for you to consider and research both and make your own decision.

Lastly, about the drinking, I know it's a hassle, but with either surgery you're basically ambushing the surgery's chance of success when you drink within 30-60 minutes of eating.  The water helps the food get out of your pouch (RNY) / sleeve (DS)  more quickly, which a) allows you to eat more and b) numbs your ability to judge how much you have eaten and can stretch it out, among other issues.  Countless people find that they are stalling / regaining, and when someone points out that they aren't following the drinking rule & they start following it again they find that they start losing again!  These are compelling reasons to obey the rules!!

I hope this is helpful!

I must respectfully disagree with some of the things your surgeon has told you. Especially about the need to do such long-term, close follow-up with one's DS surgeon.

I will be six years post-DS come December. I haven't seen my surgeon since my 18-month check-up---my PCP orders my bloodwork, based on my surgeon's recommendations. The results are faxed to both my PCP and my surgeon, but *I* and my PCP make the decisions about what, if anything, I need to chenge in my supplements. (I do think that no one should have the DS who isn't prepared to take an active, EDUCATED role in one's own health, and NOT rely on a doctor to know everything.)

And if you'll talk with VitaLady, she'll tell you herself that the ERNY is the WORST of both the RNY and the DS, re nutritional issues. I'll let her explain than---she's about ten years post-ERNY, and really knows her stuff. The potential for malnuttrition is there with any form of WLS, and amazingly, many, mnay obese people ARE malnourished. I'm talking non-ops, here, not post-ops.

Having a baby after the DS is no harder than having one after the RNY, and possibly even easier, since DSers can consume more real FOOD.

Your surgeon may be a GREAT surgeon, but if there are only two surgeons in the US that he would trust to do the DS, he's either got some real trust issues OR he's under-educated abouot the DS.

 Oh, Tamalam, i fear you have been lied to. If the information you have below comes from your surgeon, he is either very dishonest or not very current on the medical literature. 

  I know that you can have a baby after DS but it's just that much harder than with RNY.
That's simply not true. Please ask him to show you the evidence, because there are many pregnancies post-DS and a medical journal article that found that the babies were very healthy. There is simply no reason that the DS would affect fertility any more than the RNY. 

  DS is so drastic and requires such close follow-up that there are only two surgeons in the entire country whom he would recommend to me, and they are located in the DC area 
There are dozens of top-notch DS surgeons. The one in Miami is Michael Gagner. My surgeon in NY, Dr. Pomp, is at one of the best medical centers in the world. You can find more at duodenalswitch.com. It's true that surgeons have to be more skilled and educated to do the DS, but that made me feel safer. I got through without a hitch. Malabsorption does not meal malnutrition. My blood levels of vitamins and protein are perfect. I do follow the rules.   

DS is so drastic that your body just can't keep up.  
I don't understand this comment. I'm extremely healthy post-DS with cured diabetes, at normal BMI, with normal labs, normal blood pressure. And, I'm 58 years old. Healthy as a horse. I don't eat empty carbs. I eat healthier than I have ever in my life. I eat meals with my family. I don't have to eat differently. I don't throw up ever. I can't eat cake very often because my body does absorb I'm glad I can have a birthday cake with my daughter; I don't dump, but I don't abuse the privilege  of occasionally having a celebration. Just like normal people.  it. I'm afraid your facts aren't facts.

The last thing is that DS'ers tend to have really bad issues with gas and loose, smelly, icky  stools for the rest of their lives.   
That is one of the big myths that RNY surgeons spread. In fact, a medical journal article found that the DS had no more problems than the RNY. I don't have loose or smelly stools (or any more smelly than my family members, doesn't your stool smell?) I have learned to avoid foods that give me gas. I take probiotics daily. Not very difficult. 
 
With either surgery you're basically ambushing the surgery's chance of success when you drink within 30-60 minutes of eating. 
Simply, totally, not true with the DS. I drank with meals throughout the weight loss period, I still drink with meals and I am of normal weight nearly 5 years out.

Please, please study more about the DS--not only what your surgeon says. He stands to make money from your choosing the RNY. This decision is for the rest of your life. Your surgeon doesn't have to live with the results, every day, every meal, every moment. 

I had this surgery to be healthier. I didn't want to regain the weight. I knew I could comply with the DS diet for the rest of my life. The hunger monster is gone.  I was a very good dieter and lost all the weight several times in my life. I just fell back into my old habits because of overwhelming hunger. With the DS, I haven't done that because my appetite is vastly reduced. The hunger hormone, gherlin, is eliminated, since that part of the stomach is cut away. I can't eat a huge restaurant meal, nor do I want to.  I'm queen of the take out box. I usually eat about one-third of an entree. My surgeon made my sleeve small because of my diabetes. I don't dump and I've lost all the weight. 

I beg you. Please go to duodenalswitch.com and read the profiles before you alter your body permanently. Please see a surgeon who does all the surgeries.