REVISION PRE-OPS ONLY! Post-ops, read about the DS at your own risk.

If you have not THOROUGHLY studied the benefits of the duodenal switch (DS), you cannot make a fully informed decision about which surgery is the best one for you:

1. The DS has by far the best average weight loss of any of the surgeries – a statistical fact
2. More importantly, the DS has by far the best average LONG TERM MAINTENANCE of weight loss of all surgeries– a statistical fact
3. The DS has by far the best CURE RATE FOR TYPE 2 DIABETES, including LONG TERM CURE, even with weight regain (the others have substantial rates of diabetes returning, especially with the far more likely weight regain) – a statistical fact
4. The DS is suitable for ANYONE who qualifies for bariatric surgery, and not just SMOs, which has been recognized by the ASMBS, ACE, Medicare, and most insurance companies, even for BMIs >35 with a serious co-morbidity (especially if that is diabetes or hypercholesterolemia – a statistical fact
5. The DS has the easiest post-op dietary regimen of all of the surgeries – FAT IS YOUR FRIEND.  Little to no restriction on eating delicious high fat, high protein foods, because you don’t absorb much fat – and your cholesterol and triglycerides will plummet, without meds
6. Good DS foods include marbled steak, crab legs with butter, chicken WITH the skin, cheeseburgers with all the fixings (but hold the bun), scallops sautéed in butter, cheese of every sort, eggs – and BACON!
7. No dumping, no food getting stuck, no limitations on drinking with meals, no sliming or “productive burping," no fills and unfills, no stoma blockage, no marginal ulcers, no restrictions on taking NSAIDs

However, you should NOT consider the DS if you

1. Are too stupid to follow the simple rules of the DS: eat high protein, take your supplements, get your labs done diligently and adjust your supplements as necessary
2. Are too lacking in self-control to manage/time your overall intake of refined carbs to avoid weight gain and gas
3. Are too sheep-like to argue with your PCP or surgeon for the right to have the most effective WLS
4. Are too passive to fight your insurance company to get the DS, when most of them will LOSE on appeal
5. Are too cowed by doctors to stand up to them in the future, to explain what surgery you had and how your treatments need to be tailored
6. Are too submissive to advocate for yourself
7. Are too weak to be certain that you will ALWAYS ensure your access to necessary protein, supplements, lab tests and other medical care
8. Are too dim-witted or so brainwashed by Judeo-Christian “morality" to understand that eating delicious flavorful food that you enjoy and which is right for your anatomy is not sinful or gluttonous – it is wonderful!
9. Are so self-loathing that you feel you need to suffer to atone for your sins in order to enjoy life with weight loss surgery

Remember:

1. Insurance coverage for the DS is expanding all the time, and even if your policy does not cover the procedure you have a good chance of getting it covered on appeal
2. Only a qualified DS surgeon can help you figure out if the DS is for you - if you see a RNY surgeon, he is going to tell you to have a RNY
3. If you see a surgeon who SAYS he offers the DS, but then tries to talk you into something else, odds are you’ve gone to a “bait-and-don’t-switch" surgeon – check the surgeon list at DSFacts.com before you go.
4. WARNING: More and more insurance companies are instituting a “one bariatric surgery per lifetime" restriction on their policies, no matter WHO paid for the first surgery – and you may not get a second chance to have a revision if you pick a surgery that doesn’t work for you in the first place
5. Revision patients lose more slowly and lose less on average
6. Revisions are MUCH more dangerous surgeries than virgin surgeries
7. Think about the psychological damage it would cause you to work your ass off to work your ass off with a less effective surgery – only to have it fail

THINK TWICE, CUT ONCE!

For more information, please come over to the DS forum here, or go to www.DSFacts.com

I actually found your post very informative.  Thank you :)

Wow.. I'm Judeo Christain and you just offended the heck outta me ... AND your enthusiasm for the DS is a bit scary (in a brainwashed cult like way)  It's true I had RNY, but I could care less what surgery other people have .. it's up to them. You really make it sound like unless you have a DS, you're an idiot. I wonder if you habitually tell people what it best for them and how stupid they are for not being like you... I bet you are really popular and people just love you.- insert eye roll here -  

So, let's review.

You're on the Failed WLS board. Can we assume you are researching because your RNY failed you?

If you reread what I wrote, what I said was IF you have the following characteristics, including being brainwashed by your Judeo-Christian "morality" into feeling the need to suffer to enjoy the fruits of WLS, then you should not have the DS. I didn't say "if you are Judeo-Christian, you don't deserve the DS" or "if you are Judeo-Christian, you are too stupid to have a DS." Read it more carefully. And then ask yourself WHY you read into what I wrote an attack on yourself personally.

I don't tell people they have to have a DS. I tell people they need to know the FACTS about the DS before they make whatever decision they want to make - to be sure their decision is a fully informed one. I don't give a rat's ass what surgery they have. Even if I PERSONALLY think they are an idiot - it's no skin off of my nose.

As for your concern for my popularity, please, be assured that it isn't a concern of mine. In fact, take a look at this: http://www.obesityhelp.com/forums/DS/3484967/Who-benefited-f rom-DSers-posting-on-other-forums/

I'm sure you will make the best decision possible (insert eyeroll) for yourself, assuming you are looking into a revision, since you take SO personally the FORM of information that you receive on the interwebz. But please, feel free to be offended if you wish - just know that it comes from your misreading of what was written. If you CHOOSE to include yourself in the description, then - well, if the shoe fits ...

My RNY is working fine, thanks. If I had a DS, it would probably be fine too. I lurk everywhere on these boards - even the men's forum (and I'm clearly not a man). Assumptions are generally flawed without adequate evidence. For instance, because the Bible cautions against excessive anything – you assume that Christians hold some sort of animosity towards those who overeat… assumptions, assumptions- Obesity isn’t about mere overeating and a lack of self-control. It’s a medical illness that needs a surgical cure and thank God that God gave doctors the skill to cure me. Anyway, I was offended because your tone was clearly anti- Judeo Christian - and don’t try to deny it. Your hostility towards Christians should come as no surprise though – your entire post reeked with anger. Perhaps if you got right with God, you would have more peace in your life – It’s a thought. Oh, but I guess I’m not supposed to say that. It’s OK for people to disrespect my religion, but not OK for me to defend it.  

I have to reiterate.....WOW!  Diana, I sincerely suggest you reread your words when you are not so angry and defensive.  Perhaps you didn't mean to come across that way, but I have to say it is very easy to see why somebody (including myself) would be offended by your comments.  Mia is correct in that your post truly does 'reek' of anger and the response you sent to her was truly hitting below the belt.  Everybody has the right to chose what is best for them, without being judged or mocked, be it RNY, DS, or just plain old fashioned dieting.  Hopefully you will take the time to reread your words when you are not so upset and will be able to see what many others *****ad this exchange will see. 

Absolutely, 100% incorrect.

In fact, if you go to Google and search, "Problems with the Duodenal Switch", you will find literally thousands of articles, many written by surgeons that used to do this very risky surgery, about the myriad of problems that occur with it.

Dianna hates to have anyone actually do their own research.  She only wants you to look at her pet sites, where the data is phony as all get out, manipulated and totally misleading.

Lets look at just one of her claimed "benefits".  The rate of Type II Diabetes "Cure".  First of all, medically speaking there is NO CURE for any form of diabetes.  You can put it into remission, but you can NEVER "cure" it.

The DS, the RNY, the Vertical Sleeve Gastrectomy all have equal rates of Type II Diabetes remission.  The data Dianna utilizes if many years old, comes from a very small study and it was performed by and paid for by DS surgeons.  Can you say, "Biased"?

Look at university studies, or studies by people like diabetes organizations, not ones by individual surgeons or clinics.  They tend to be a LOT more comprehensive, and a lot more free from bias.

You will notice that Dianna does NOT bother to mention the chronic diarrhea that afflicts about 40% of DS patients.  Or the problems with constant bloating gas that afflicts many DS patients

She also does not bother to mention the studies that are showing that rearranging the intestines leads to intestinal wall breakdown/erosion after about ten years or so.

Or the fact that the malabsorption effect is essentially gone in 1-2 years, because the body adapts.

Be very, very careful of accepting anything that ANY fanatic presents. They are 100% behind their choice, and they adamantly refuse to look at any data that conflicts with their pet beliefs.

Do your own research.  You can research any weight loss procedure on your own, using Google, Bing, or any other search engine.  You can go to the Mayo clinic web site, and many others, and read unbiased information about weight loss procedures.

I researched ALL forms of weight loss surgery for over 5 years, utilizing two University Medical School libraries, two other University libraries, and the Internet.

You don't have to be that obsessive about it, but you should do some research on your own.  Go into your weight loss surgery as an informed patient, not trusting what anyone else tells you about it, but knowing what it is from your own study.

You may end up choosing the DS, or the RNY or the VSG or even the Band.  That is YOUR choice, just make it an informed choice.

And OldManiac is back!

Never gives ONE citation for any of the bull**** he spews. NEVER. Because it is all lies. "Literally thousands" - bwahahaha! Put in a link to even a half-dozen you OldLiar!

Here's one about 15 years of DS experience.
http://files.meetup.com/379062/DUODENAL%20SWITCH%20LONG-TERM%20RESULTS.pdf

I dont know much about the switch I have to say.  Are you at goal?

Anecdotes are not statistics.

This is a comparison from two papers of the long-term results with the RNY, VBG and LapBand (Shah et al.), and with the DS (Hess).  The RNY, VBG and LapBand study can be found at http://jcem.endojournals.org/cgi/content/full/91/11/4223, and the Hess study was published in Obesity Surgery, 15, 408-416 (2004).

 Even if the curves are oppositely oriented, and one measures percent weight change, and the other percent excess weight lost, and even if you assume that both DSers and RNYers end up at the same initial maximum EWL% (which isn't the case), the curves are pretty directly comparable.  The first is from the Shah study; the second is from the Hess study.

FIG. 1. Weight changes among subjects participating in the Swedish Obese Subjects study over a 10-yr period (11 ). There were 627 control subjects who did not undergo bariatric surgery, 156 who underwent banding, 451 who underwent vertical banded gastroplasty, and 34 who had gastric bypass.

Also, there is this study from Christou, reporting long-term RNY results: http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pub med&pubmedid=17060766
in which he reports:

There was a significant increase in failures and decrease in excellent results at 10 years when compared with 5 years. The failure rate when all patients are followed for at least 10 years was 20.4% for morbidly obese patients and 34.9% for super obese patients. CONCLUSIONS: The gastric bypass limb length does not impact long-term weight loss. Significant weight gain occurs continuously in patients after reaching the nadir weight following gastric bypass.


What matters is not where you end up at 1 year out - it's where you are at 10 years out.