BMI 55 and over

Louise,

Are you insinuating that those of us that have had surgeries other than OHIP covered surgeries don't have the right to inform newbies of what is available to them?   I think it would be very unfair to exclude discussion of anything other than RNY and VSG when newbies are asking questions.  You'd be surprised how far some people are willing to go to get the money to pay for their surgery of choice.  If those of us with surgeries other than RNY and VSG didn't share our own journeys, many people would be left uninformed of all surgical choices.  Just because you don't want to self pay or can't self pay it doesn't mean that others out there aren't interested in hearing about ALL options.

"LOL @ DS envy.  Careful, she might post some links about awful DS side effects LMAO"

Ha ha Kel!!!  You could make so much money with your ability to read into the future!!

Go read the failed surgery boards to hear about some of the challenges of living with the DS, lol!

You won't find any on that board, and to be honest, the challenges are the same for any weight surgery -you have to be compliant with your vites and your protein.  The RNY has it's own challenges that many people on this board are able to handle quite successfully, but it involves some will power.  Good luck with that.

Do you work for OHIP or something?  Your research abilities suck, try again.

Here's some studies to read on this:

http://www.dsfacts.com/Bowel-Function-After-Duodenal-Switch.html

What the experts say...

Baltasar et al., "Gastric emptying in patients with morbid obesity treated with a duodenal switch", May 1997. [36]

81.3% of Duodenal Switch patients experience normal gastric emptying.

Gary Anthone, MD, "The duodenal switch operation for morbid obesity", Aug 2005. [9]

The average number of bowel movements per day for 43 pre-op patients was 1.9, 421 patients six months post-op was 2.7, 316 patients twelve months post-op was 2.6 and 113 patients > thirty six months post-op was 2.8.

Wasserberg et al., "Bowel habits after gastric bypass versus the duodenal switch operation.", Dec 2008. [19]

Although duodenal switch is associated with more bowel episodes than gastric bypass, the difference is not statistically significant. Bowel habits are similar in patients who achieve 50% estimated body weight loss with duodenal switch surgery or gastric bypass.

Marceau et al., "Duodenal Switch: Long-Term Results", Nov 2007, p 1428. [2]

The negative side-effects with DS were not benign. The unpleasant odor of stool and gas and the frequent abdominal bloating were the price to pay for these patients and it was a major preoccupation for many of them. However 95% of patients declared themselves satisfied despite this handicap and no one has required reversal of the procedure for this reason.

Have a look at this great resource from the American Society for Metabolic & Bariatric Surgery:
Bowel Function Changes After Bariatric Surgery

Patiens SHOULD know their options. People have chosen to self pay once finding out about DS. Kelly should be back from Brazil shortly if not already. You may have choen to believe that DS is only for high BMI people but that is not the case. Many patients with low BMIs get DS and many surgeons perfom it. In fact, the intestine switch portion is performed on normal BMI patients looking to revolve diabetes. It's responsible to let people know what is out there.

I'm not really going to take the time to say too much, but just wanted to give you some info about my pre-op testing...

I went to the US... My pre-addmission and anyone else that went to Barix involved the following (at minimum):
1) blood work
2) chest X-ray
3) urinalysis
4) ECG/EKG
5) U/S of Gallbladder  (if not removed already)
6) 2 Hour nutrition class
7) Meeting with in-house physician for clearance
8) Meeting with Respiralogist

Ok - I take offence to your comment about us DS self-payers looking for a "good deal".
I paid for my lap DS out of my pocket - went to France - why?  To have one of theeee best bariatric surgeons IN THE WORLD perform my surgery.  I was not looking for a deal.  I was looking for the best to operate on me.  Dr. Michel Gagner was the first in the world to perform lap DS and lap VSG - and I chose him not because of the "good deal" but for his expertise.

And it wasn't that I met him and "bam he did the surgery".  I had a chest x-ray, bloodwork, endoscopy, colonoscopy, ECG, EKG....and forget what else!

My starting BMI?  46 - and guess what?  DS was the best choice for me.  Why?  I do not have a blind stomach, I have no problems taking my NSAIDS, I have my pyloric valve and oh yeah, I **** once a day!

I will be 6 months since my surgery and have lost just under 80 lbs.  Would I like to share my story with any newbies who are contemplating self-pay?  Damn right.

Here is the randomized study, just published in the British Journal of Surgery, demonstrating a superior weight loss with the DS. This is level 1 scientific evidence that dent and ohip can no longer deny:  Br J Surg. 2010 Feb;97(2):160-6. Randomized clinical trial of laparoscopic gastric bypass versus laparoscopic duodenal switch for superobesity. Søvik TT, Taha O, Aasheim ET, Engström M, Kristinsson J, Björkman S, Schou CF, Lönroth H, Mala T, Olbers T. Departments of Gastrointestinal Surgery, Oslo University Hospital Aker, Oslo, Norway. [email protected] BACKGROUND:: Laparoscopic Roux-en-gastric bypass (LRYGB) and laparoscopic biliopancreatic diversion with duodenal switch (LDS) are surgical options for superobesity. A randomized trial was conducted to evaluate perioperative (30-day) safety and 1-year results. METHODS:: Sixty patients with a body mass index (BMI) of 50-60 kg/m(2) were randomized to LRYGB or LDS. BMI, percentage of excess BMI lost, complications and readmissions were compared between groups. RESULTS:: Patient characteristics were similar in the two groups. Mean operating time was 91 min for LRYGB and 206 min for LDS (P < 0.001). One LDS was converted to open surgery. Early complications occurred in four patients undergoing LRYGB and seven having LDS (P = 0.327), with no deaths. Median stay was 2 days after LRYGB and 4 days after LDS (P < 0.001). Four and nine patients respectively had late complications (P = 0.121). Mean BMI at 1 year decreased from 54.8 to 38.5 kg/m(2) after LRYGB and from 55.2 to 32.5 kg/m(2) after LDS; percentage of excess BMI lost was greater after LDS (74.8 versus 54.4 per cent; P < 0.001). CONCLUSION:: LRYGB and LDS can be performed with comparable perioperative safety in superobese patients. LDS provides greater weight loss in the first year. Registration number: NCT00327912 (http://www.clinicaltrials.gov). Copyright (c) 2009 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.

Ruth, stop it, you're pushing the DS in this thread.  Don't you know that's not allowed?

I know, I know, I just can't help myself.
Push, push and push.

LOL

OHIP is all about saving $$ not lives from what it appears to me..*shrugs shoulders*.

I wanted an experienced Surgeon..and I am glad I had my surgery in the US, and I had plenty of pre-op tests before I was approved. 

I also have to add, that I have been in the hospital here in Ontario numerous times for surgeries before I had my WLS, as well as saw specialists here. I was treated horribly every time due to my weight. NOT once was I ever treated that way over in the US. Every single healthcare professional I dealt with in the US was kind and huge hearted. Something I never recieved here. Nothing will ever change my mind about the care in the US compared to here in Ontario because I see how differently I am treated now I am @ goal. Everyone is super nice...it makes me sick. Yes maybe that is here in Windsor but it certainly left a bad taste in my mouth about our healthcare system. Maybe years from now everyone will be experienced and have more knowledge, and be able to treat the overweight a little nicer because they are doing the surgeries here, but for now thats just my opinion.

I've had the same experience.  I had my appendix out when I was 14 and I told my ********urgeon I had lost 14 pounds, he told me "I couldn't lose 14 pounds if I walked to Toronto and back" (from Belleville, a 2 hour drive) Plus he butchered me.  I swear he cut me open and didn't care how big he cut me b/c I was fat.  Then after, I got an infection and he yelled at me and jammed tweezers in my wouds to open them up.  I was 14!!  Pretty much every illness I have had in my life until now was b/c I was fat and every doctor I ever dealt with has made me feel awful for it except the surgeons and doctors in the US.  I had such a wonderful expereince there.  I thin the issue here is people who have never gone OOC would never know how bad it can be here, b/c they have never experienced the service standards in the US...But they have to wor for your business, b/c you have to pay for it.

I have a wrecked right knee courtesy of fat blindness of two orthopedic surgeons and one emergency room doctor and my GP.
I tore my cartilage- when the incident is described to someone who has not seen me- they tell me it is an emergency and should be operated on immediately. When was my surgery? Three years later, and only after I pestered my doctor and found a third orthopedic surgeon who could see beyond me being fat and forty. The surgeon who did the first and second operation-the second one should have been done 6 weeks earlier- he discovered that when he did the procedure- I had a spinal - so I could see his look of fright at what he had missed. He then lambasted me for being Fat. If he had done the first operation correctly or listened to me when I had the locked knee- a lot of pain and damage would have been avoided.
I agree there is a fat prejudice and we get second class treatment most of the time. There is a different dynamic in the US re medical care- as long as you have $$$$$$$. If you don't - it's worse than here.