Help ..today...meeting with Surgeon to discuss RNY revision
Kerry,
Please feel free to share any and all of your personal experiences. I LOvE hearing about your success!! I will share mine as well. ....
The issue I had (many posts ago) was your inference that ALL Rny's had the problems that you suffered with. My point is that there are many differences even with the "Rny" crowd; even the type of Rny. My guess is that the stats, reports and heresay that many refer to when pointing out negatives of the Rny, are of the proximal crowd. But, I do not have any paprs, or stats in front of me to share. Sorry. The main reference I have is, like you, my own experience and a lot of education with that. I have been working in the Bariatric field in some capacity for six years. It has been my pleasure to be associated with hundreds of post-ops and learn from them. So, I KNOW that all do not dump, that all do not need to chew food to mush, that many can eat rice, meat of all types, etc. ..... As for the malabsorption degrees: They vary within the Rny's types. Proximal, Medial, Distal and Extended.
Good for you for calling all the best docs for opinions. I'm glad you found a surgeon that was just right for you. I too consulted with many surgeon's and some of them are the same as those you listed. I always recommend having several consults prior to a major surgery. Dr. Schlesinger was the right guy for me. I'm not sure why you came at me so offensively regarding my choice of surgeons? I thought we were debating Rny facts?
I NEVER tell anyone NOT to have a DS. I do tell people that if they CAN'T have a DS that there are other really great options and an ERny is certainly one of them!
You said, "Anyway, I'm sorry if I offended you, that was never my intent, I just want people to get all the information possible before they get any WLS."
I totally agree with you Kerry. "all the information possible"..... about all proecdures, right? And, not just opinions or personal experience?
....I'm really glad you are so happy and able to enjoy life to it's fullest! Seriously, .......enjoy your journey!
Please feel free to share any and all of your personal experiences. I LOvE hearing about your success!! I will share mine as well. ....
The issue I had (many posts ago) was your inference that ALL Rny's had the problems that you suffered with. My point is that there are many differences even with the "Rny" crowd; even the type of Rny. My guess is that the stats, reports and heresay that many refer to when pointing out negatives of the Rny, are of the proximal crowd. But, I do not have any paprs, or stats in front of me to share. Sorry. The main reference I have is, like you, my own experience and a lot of education with that. I have been working in the Bariatric field in some capacity for six years. It has been my pleasure to be associated with hundreds of post-ops and learn from them. So, I KNOW that all do not dump, that all do not need to chew food to mush, that many can eat rice, meat of all types, etc. ..... As for the malabsorption degrees: They vary within the Rny's types. Proximal, Medial, Distal and Extended.
Good for you for calling all the best docs for opinions. I'm glad you found a surgeon that was just right for you. I too consulted with many surgeon's and some of them are the same as those you listed. I always recommend having several consults prior to a major surgery. Dr. Schlesinger was the right guy for me. I'm not sure why you came at me so offensively regarding my choice of surgeons? I thought we were debating Rny facts?
I NEVER tell anyone NOT to have a DS. I do tell people that if they CAN'T have a DS that there are other really great options and an ERny is certainly one of them!
You said, "Anyway, I'm sorry if I offended you, that was never my intent, I just want people to get all the information possible before they get any WLS."
I totally agree with you Kerry. "all the information possible"..... about all proecdures, right? And, not just opinions or personal experience?
....I'm really glad you are so happy and able to enjoy life to it's fullest! Seriously, .......enjoy your journey!
Joyce Rny 2/11/03-> ERny 12/26/07-> Duodenal Switch 5/12/2010
www.dsfacts.com , www.dssurgery.com , & www.duodenalswitch.com
Dr. Schlesinger was the right guy for me. I'm not sure why you came at me so offensively regarding my choice of surgeons? I thought we were debating Rny facts?
Hmm, well, my intent was not to "come at you offensively" but to say truthfully what Dr. Schlesinger did when I spoke to him. To me he came off as a shyster trying to convince me to let him revise me to RNY using either lies, deceit or ignorance. You experience with him was no doubt much different and I don't doubt for one minute that he treated you well and gave you what you were looking for. I was only speaking of my experience with him.
As an aside, I know people who did not get along with Dr. Rabkin, so I completely understand how different people can have different perceptions and reactions. I would never go to Dr. Schlesinger and I know people who wouldn't go to Dr. Rabkin even though I think he's the best.
Choosing your surgeon is a very personal decision as is the WLS you choose and I'm not advocating that anyone do what I did or choose as I did. I do advocate that anyone looking into WLS should seriously look into all their options and consult with a number of surgeons once they know what WLS they want.
Kerry
Hmm, well, my intent was not to "come at you offensively" but to say truthfully what Dr. Schlesinger did when I spoke to him. To me he came off as a shyster trying to convince me to let him revise me to RNY using either lies, deceit or ignorance. You experience with him was no doubt much different and I don't doubt for one minute that he treated you well and gave you what you were looking for. I was only speaking of my experience with him.
As an aside, I know people who did not get along with Dr. Rabkin, so I completely understand how different people can have different perceptions and reactions. I would never go to Dr. Schlesinger and I know people who wouldn't go to Dr. Rabkin even though I think he's the best.
Choosing your surgeon is a very personal decision as is the WLS you choose and I'm not advocating that anyone do what I did or choose as I did. I do advocate that anyone looking into WLS should seriously look into all their options and consult with a number of surgeons once they know what WLS they want.
Kerry
Kerry,
You wrote "Choosing your surgeon is a very personal decision as is the WLS you choose and I'm not advocating that anyone do what I did or choose as I did. I do advocate that anyone looking into WLS should seriously look into all their options and consult with a number of surgeons once they know what WLS they want."
I totally agaree! We're on the same page 
You wrote "Choosing your surgeon is a very personal decision as is the WLS you choose and I'm not advocating that anyone do what I did or choose as I did. I do advocate that anyone looking into WLS should seriously look into all their options and consult with a number of surgeons once they know what WLS they want."
I totally agaree! We're on the same page Joyce Rny 2/11/03-> ERny 12/26/07-> Duodenal Switch 5/12/2010
www.dsfacts.com , www.dssurgery.com , & www.duodenalswitch.com
What information is skewed? How about the whole paragraph?
RNY causes dumping, food sticks in your stoma if you don't chew to mush, rice and meat are both very difficult foods for a RNY patient to eat, you have a blind stomach that's prone to develop ulcers, which cannot be scoped and is only accessible with surgery and you cannot take any NSAID. You're also at risk for B12 deficiency and most likely need B12 injections for the rest of your life and unless you have a Distal RNY, you don't have enough malabsorbsion to really help you lose weigh.
Not all RNYers dump. Actually the figure usually rests around 40%. I don't have to chew my food to mush. The part about the blind stomach is true...although some RNYers are able to take NSAIDS depending on what it is for and how much. The B-12 statement is inaccurate...if you look around OH and see that injections are not the *norm*. I have not had one since my surgery 5 years ago...and my labs I just got in the mail came back with HIGH B-12. You will see that a great deal of RNYs are done proximally...so that blanket statement is inaccurate. Go to the RNY board and check out all the proximal folks that have succeeded with weight loss.
With all of that said....as a successful RNYer...I will often tell people to check out the DS if they don't know about it already!!!! I think in many cir****tances it is MUCH more appropriate than RNY. I'll be the first to admit that if I EVER need a revision you can bet your socks I will ask for a DS!!! If I would have known about it when I had my RNY, it likely would have been my choice. My surgeon group didn't do it at the time, but they do now.
RNY causes dumping, food sticks in your stoma if you don't chew to mush, rice and meat are both very difficult foods for a RNY patient to eat, you have a blind stomach that's prone to develop ulcers, which cannot be scoped and is only accessible with surgery and you cannot take any NSAID. You're also at risk for B12 deficiency and most likely need B12 injections for the rest of your life and unless you have a Distal RNY, you don't have enough malabsorbsion to really help you lose weigh.
Not all RNYers dump. Actually the figure usually rests around 40%. I don't have to chew my food to mush. The part about the blind stomach is true...although some RNYers are able to take NSAIDS depending on what it is for and how much. The B-12 statement is inaccurate...if you look around OH and see that injections are not the *norm*. I have not had one since my surgery 5 years ago...and my labs I just got in the mail came back with HIGH B-12. You will see that a great deal of RNYs are done proximally...so that blanket statement is inaccurate. Go to the RNY board and check out all the proximal folks that have succeeded with weight loss.
With all of that said....as a successful RNYer...I will often tell people to check out the DS if they don't know about it already!!!! I think in many cir****tances it is MUCH more appropriate than RNY. I'll be the first to admit that if I EVER need a revision you can bet your socks I will ask for a DS!!! If I would have known about it when I had my RNY, it likely would have been my choice. My surgeon group didn't do it at the time, but they do now.
Roux En Y gastric bypass the typical surgery that is initially performed on people who have not had a previous weight loss surgery, is not nearly as malabsorptive as the Duodenal Switch weight loss surgery. Not only is this important for weight loss, but for the cure rate for diabetes. The Roux En Y Gastric Bypass relies more heavily on restriction versus Malabsorption for weight loss.
The most important aspects of Roux En Y Gastric Bypass versus the Duodenal Switch are ultimately clear in the below article:
The rates of resolution for duodenal switch and gastric bypass were: diabetes, 100 percent vs. 60 percent; high blood pressure, 68 percent vs. 38.6 percent; high cholesterol, 72 percent vs. 26 percent; acid reflux; 48.5 percent vs. 76.9 percent, the study authors found.
DS: 100% cure for diabetes
Roux En Y: ONLY 60% cure for diabetes
DS: 68% cured of HBP
Roux En Y: 38.6% cured of HBP
DS: 72% cured of High Cholesterol
Roux En Y: just 26% cured of High Cholesterol
Copyright © 2009 ScoutNews, LLC. All rights reserved.
URL: http://health.msn.com/health-topics/high-blood-pressure/articlepage.aspx?cp-documentid=100239671
Body by God; alterations by Buchwald. I love Jesus. I so so so appreciate my DS.
Kathy,
since this is a REVISIOn forum, it matters not what the "innitial" surgery stats are! (you'll find a handful of them to support just about every view point)....
What matters is what options can be available for those seeking Revision from their current situation! Going to the golden DS is NOT always possible. To those people I strongly encourage research with other options.
My Extended Roux en Y has given "me" a great outcome! An extended Rny has little in common with the intial or most common "proximal" that you are quoting stats on.
I had insulin dependent Diabetes, high blood pressure, heart blockage problems, etc. I am 100% medication and treatment free from all of those now and I didn't have a DS! ..... WEIGHT is the issue for bad health....NOT a procedure type. If someone has a DS but doesn't get to their healthy range then I suspect their medical issues will not be cured for long. The same would apply to my ERny or any of the procedures.
Weight is the issue. The DS is absolutely one of the FIRST revision considerations that should be made. But....I since all of us are not created equal; neither are our paths to a healthy weight.
since this is a REVISIOn forum, it matters not what the "innitial" surgery stats are! (you'll find a handful of them to support just about every view point)....
What matters is what options can be available for those seeking Revision from their current situation! Going to the golden DS is NOT always possible. To those people I strongly encourage research with other options.
My Extended Roux en Y has given "me" a great outcome! An extended Rny has little in common with the intial or most common "proximal" that you are quoting stats on.
I had insulin dependent Diabetes, high blood pressure, heart blockage problems, etc. I am 100% medication and treatment free from all of those now and I didn't have a DS! ..... WEIGHT is the issue for bad health....NOT a procedure type. If someone has a DS but doesn't get to their healthy range then I suspect their medical issues will not be cured for long. The same would apply to my ERny or any of the procedures.
Weight is the issue. The DS is absolutely one of the FIRST revision considerations that should be made. But....I since all of us are not created equal; neither are our paths to a healthy weight.
Joyce Rny 2/11/03-> ERny 12/26/07-> Duodenal Switch 5/12/2010
www.dsfacts.com , www.dssurgery.com , & www.duodenalswitch.com
I agree that healthy weight is the most important. There are people who can get there with diet and exercise and keep it off forever too, so I don't care how it is done, as long as person can be healthy.
However, there is research into the Duodenal Switch as a cure for Type I diabetes or Non-insulin dependent diabetes. It just cannot be done with massive weight loss as well.
In this regard, if a person is diabetic; the Duodenal Switch is a great surgery to be revised to.
And, it is not for lack of simple carboyhydrate absorption, because DSers still absorp these carbs.
So, DS pretty much cures diabetes.
Body by God; alterations by Buchwald. I love Jesus. I so so so appreciate my DS.
On June 4, 2009 at 5:15 AM Pacific Time, Kerry J. wrote:
Marcia,Your RNY gave you restriction which made it impossible to eat much, it didn't give you any malabsorbsion. You just gradually found a way to eat around the restriction.
The DS has some restriction, but not as much as RNY so you can eat more, you also get you're pylorus back so you don't have to chew your food to mush and you don't dump. The DS also has malabsorbsion so that you only absorb 20% of the fats you eat, 60% of the protein and 60-70% of complex carbs. You do absorb 100% of simple carbs/sugars so you have to stay away from them.
There are two things you have to do with DS, #1 stay away from simple carbs and #2 get blood drawn to see how your levels of Iron, Calcium, vitamins A, E, K & D are and then take the appropriate supplements. If you can't commit to these things, don't bother getting a revision to DS or anything else as you will not be successful.
WLS is not a free ride to the cookie and sugar line, it's a tool you use to get healthy and thin. Of all the tools, the DS is the most powerful.
Kerry
"The Joy of the Lord is your strength." Nehemiah 8:10START: 330 CURRENT: 274.5 lbs GOAL: 190 TOTAL: 55.5 lbs
The normal RNY gives little malabsorbation which doesn`t last more then the initial 2 years. The reason is easy to explain - only 100-150 cm of the intestines are bypassed, which leave more then 75% of the small intestines in place. The body can and does adjust to that chance, and after 2+ years out, calories are no longer malabsorbed at all. That`s why so many, many people struggle with regain.
The distal RNY has more malabsorbation because more intestines then 150 cm are bypassed, and the ERNY has as much malabsorbation then the DS, or even more, bypassing roughly 90% of the intestines. The ERNY is usually done as revision procedure when someone gains weight back after the initial malabsorbation has stopped and/or the pouch and stoma are dilated. The ERNY requires more supplements then the DS and has a greater risk of malnutrition, because the RNY pouch makes adequat nutrition through normal food more difficult.
@ Marcia: I STRONGLY recommend you to make a consult with a revision surgeon that does ALL revisions availible. You talked to someone who is not able to do RNY to DS revisions and therefore recommended to you what he can do - band over bypass or RNY to ERNY. There are other choices!! The band over bypass is not very effective and most likely you won`t loose all you need to loose. The band is no help if your downfall are sweets, ice cream, cake, chocolate ect. go right through.
The distal RNY has more malabsorbation because more intestines then 150 cm are bypassed, and the ERNY has as much malabsorbation then the DS, or even more, bypassing roughly 90% of the intestines. The ERNY is usually done as revision procedure when someone gains weight back after the initial malabsorbation has stopped and/or the pouch and stoma are dilated. The ERNY requires more supplements then the DS and has a greater risk of malnutrition, because the RNY pouch makes adequat nutrition through normal food more difficult.
@ Marcia: I STRONGLY recommend you to make a consult with a revision surgeon that does ALL revisions availible. You talked to someone who is not able to do RNY to DS revisions and therefore recommended to you what he can do - band over bypass or RNY to ERNY. There are other choices!! The band over bypass is not very effective and most likely you won`t loose all you need to loose. The band is no help if your downfall are sweets, ice cream, cake, chocolate ect. go right through.
Thank You for all of your information. So wonderful to hear everyone's thoughts on revisions and the particulars of various procedures....
I will be having my upper endoscopy..(scope)....with my actual revision surgeon doing the procedure...
After that procedure ....he will suggest the options that he feels would be best for me ...due to what he finds, my lifestyle, and my other medical conditions.
This surgeon actually does all of the revisions available....so I am pleased about this. He has done many revisions.
I, also am concerned about the Band......need to learn a lot about it before I would be comfortable with this choice.
I would rather have a revision to my RNY.....if the surgeon feels that this would work....
But......until I have the scope....on Monday....I will not know what he thinks.....I am hoping that my daughter (nurse) can come with and ask him questions and write things down after the procedure.....because I know that I will be in La La Land.....and not remember anything......If not my poor hubby will be there....and heaven knows what he will ask or write down.....lol
I really do learn a lot at the seminar and meeting with the surgeon and dietician......especially where protein drinks are concerned.....they definitely do not want us to use them.....they want 70-100 grams of protein daily from actual food. Need to check this out more thoroughly.
Enought rambling this mornin...lol
Have a great day all and thanks again for all of the information.....all of you!
Lots of love,
Marcia
I will be having my upper endoscopy..(scope)....with my actual revision surgeon doing the procedure...
After that procedure ....he will suggest the options that he feels would be best for me ...due to what he finds, my lifestyle, and my other medical conditions.
This surgeon actually does all of the revisions available....so I am pleased about this. He has done many revisions.
I, also am concerned about the Band......need to learn a lot about it before I would be comfortable with this choice.
I would rather have a revision to my RNY.....if the surgeon feels that this would work....
But......until I have the scope....on Monday....I will not know what he thinks.....I am hoping that my daughter (nurse) can come with and ask him questions and write things down after the procedure.....because I know that I will be in La La Land.....and not remember anything......If not my poor hubby will be there....and heaven knows what he will ask or write down.....lol
I really do learn a lot at the seminar and meeting with the surgeon and dietician......especially where protein drinks are concerned.....they definitely do not want us to use them.....they want 70-100 grams of protein daily from actual food. Need to check this out more thoroughly.
Enought rambling this mornin...lol
Have a great day all and thanks again for all of the information.....all of you!
Lots of love,
Marcia
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