RNY or DS

Okay everyone. I am having issues.

When I first researched WLS, I wanted to get a DS, but after meeting with the surgeon, I switched to wanting to do RNY because he said that I would be an excellent candidate because I am young and "not that big".  However, with doing more research, I want to do the DS.

I'm looking for your PROS/CONS of your surgery whether you had a RNY or DS.

The DS sounds like something I can handle long term, but the idea of it being a major surgery and pooping a lot scares me.

The RNY has been proven to work and has been around longer, but I'm not sure I can keep up with the teeny meals and not being able to really eat what I want.

Help me out here and tell me why you switched to a DS from a RNY, etc.

I want to be prepared when I tell my surgeon why I want to do the DS instead. I'm scared...:(

They are both major surgies. The whole pooping thing is a myth, when I'm not on antibiotics I go once or twice in the am before work. That's it. Both RNY and DS left me with stinky craps after surgery, but it tones down after awhile.

I had the RNY, I converted to a DS.

Pros of RNY: I lost some of the weight.

Cons of RNY:  I had complications due to a ring around the stoma (slight pro - it kept me from stretching my pouch).
I never was able to eat normally.
I became very anemic even though I was vitamin compliant
I never got down to my goal weight.
I was often constipated from all the calcium
Dumping syndrome

Pros of DS:

I can eat more normally. I can eat my protein sources instead of drinking them.
At 5 months past my revision date, I am at the goal set by my RNY surgeon many years ago.
As long as I eat fat, I never get constipated
I find it easier to find DS-friendly meals while out as opposed to when I had RNY.
Long-term weight loss statistics show that the DS takes off more weight and it is kept off.
No dumping syndrome
Less of the hunger hormone grehlin due to the removal of the curvature of the stomach

Cons of DS:

I get gas from high-carb offerings, but I can live with staying away.
Slightly longer recovery time, but for me that was because I was a revision patient.

I hear a lot about people converting from RNY to DS, but not the other way around. I think that alone says something.

I agree with everything Baileymouse said.

I had an RNY - I lost the weight fast and I regained it fast.  I had chronic diarrhea for years  and dumped quite a bit.  I felt like I was living on a diet and didn't like knowing how my body was going to react if I put fruit in my mouth that had a high sugar content (like watermelon), sometimes it would make me dump, sometimes it wouldn't.

Since my DS, no diarrehea, I'm eating well, the poop thing isn't a big deal, I find my bathroom issues have greatly improved with the DS.

Most of all, the long term statistics on keeping with weight off is far better with the DS than RNY.  Have you checked out www.dsfacts.com, it might help answer some of your questions.

Does your surgeon do both procedures?  If not, I'd recommend talking to an experienced DS surgeon as well.

Why are you scared?

I was originally on track to have RNY back in 2002, but got derailed after preop testing revealed that I had pulmonary hypertension. It's a long story, but it's on my profile if you'd like to read about it.

Even though I was off the track for RNY, I continued to attend the program my then-surgeon required of all his patients. I'd paid for it, so I figured I could benefit from it anyhow :-).

I saw some disturbing trends there. This was a big group, as several surgeons sent patients to it. There was, of course, a cadre of very successful patients (all RNY). They finished their year of program and went on with their lives, and as far as anyone knew/knows, all is well.

There were a surprising number of people, though, who fought and fought and fought to comply with what was expected of them, and the weight didn't come off well. At every meeting, there was word of someone else in the hospital with this or that problem--usually an ulcer or a stricture.

I listened to stories of dumping episodes, of getting food stuck episodes, of the mental/emotional challenges of having to live on highly restricted diets.....and I thought, "There's not a chance in hell I could live with this." (I should add that I have a major vomiting phobia. I'll do just about anything to not vomit. Not a good thing in some cases.)

Well, time passed, I got fatter and sicker, and eventually (again, story in my profile), it came out that the pulmonary hypertension was caused by the fat on my torso squashing my heart and lungs. It went from, "You cannot have any surgery at all," to, "You must have surgery or die."

I came back here to OH, feeling desperate because the lap band wouldn't give me enough weight loss to have any real hope of curing what was ailing me, and the RNY seemed to me like foolish butchery for not enough good results.

Someone told me then about the duodenal switch, invited me over to the DS board, which at the time was pretty much brand new, and the rest was history.

What I like about the DS:

1. 98% cure rate for type II diabetes. This was a major biggie because I had very bad diabetes.
2. Normal stomach anatomy and function is maintained. The stomach is reduced in size, but the normal stomach outlet, the pyloric valve, remains intact and functioning. There is no "stoma" with the DS or the vertical sleeve gastrectomy (VSG).
3. The intestinal changes that are done in the DS "jump start" the body's metabolism. Mine was shot to hell from a lifetime of PCOS, dieting and other factors.
4. I'd already done many years of low fat, low carb, highly restrictive dieting and I knew I sucked at it. The DS gives an eating quality of life that I find easy to live with: eat a primarily animal protein based diet. I'm a happy carnivore :-). I had to learn to restrict my carb intake, but it was a lot easier to do when I could eat meat, cheese, fish, eggs, etc. with abandon, with little regard for fat content. (DS'ers only absorb about 20% of the fat they eat, so for most of us, fat is almost a "free" food.)

I felt so strongly about the superiority of the DS to any other procedure that I traveled and paid out of pocket to have it done, rather than have the RNY done fifteen minutes from home and covered by insurance. It's been over three years, and so far, so good :-).

Please come over to the DS board and visit with us there. Lots of folks will be happy to tell you about their experiences.
 

Dr. Ikrammuddin is an excellent surgeon and can do a great RNY or DS.  He does have some reservations about doing DS on younger people, which I think is prudent in a sense but perhaps overly so?  I'm not sure if younger people tend to be more lax about supplementation than older people.  In my experience knowing bariatric patients, many younger people seem as or more responsible than their older counterparts.  Either surgery requires vigilance about labs and a good deal of supplementation.  Either surgery requires eating the proper amount of protein and curbing excessive carbohydrate consumption. 

Just as a personal note, I also had surgery at the U and I take a lot more vitamins than they recommend.  All my friends who are healthy WLS patients take more than the U recommends, even those who originally started on the U's plan!  I imagine that those who stick strictly to the U plan and don't deviate probably end up with some health problems, and those would probably hurt the DSers more because we have more malabsorption.

As for the pooping worry, I know more DSers who struggle with mild to moderate constipation than who suffer from excessive pooping.  The first few months out of surgery were not always easy for me in the bathroom dept, but I also had my gall bladder taken out at surgery and that can cause diarrhea and urgency even in non-WLS patients.

I assume from your screen name that you're 23 or so?  That is young for any WLS, really, but not like you're 15 or something.   If you are at a place in your life where you will take good care of yourself and be very proactive, and you want a DS, be ready to tell Dr. I that you want the surgery with the best odds for keeping off the weight long-term, a better quality of eating, a better resolution of co-morbidities.  Even if you don't have co-morbs, you don't want to develop them either!   And IMO one of the best things about DS is the preservation of the pyloric valve.  Having a normal but small stomach feels great! 

Good luck with Dr. I.  I think he's reasonable but you will have to fight a bit.  If it's what you want, it's worth it.  If he thinks a longer common channel than his standard 100 cm is reasonable for you because you are younger, that might be a good compromise. 

I am wondering if you have to have a very hi bmi for the ds surgery. That is what I thought, I have a band and am trying  to decide which to get rny or ds. I hate the band and things getting stuck. but my bmi is 37.8 so I am not sure. I info would help

My bmi was a 21 eleven days ago when I was revised from Rny to DS.   I'm a bit different than most since I had my revision mainly to GAIN nutrition and not necessarily to LOSE weight!  (though I have lost 9 pounds in 4 days!!! )  Don't rule out the DS.  Can you imagine losing crazy fast, not having food get stuck and then knowing the DS will keep you at a healthy weight?!!!  Oh yeah!  It Rocks!
 
Check out www.dsfacts.com  for more information and come on over to the Duodenal Switch forum to get your questions answered.  I KNOW there are oodles of DS'ers who have had low BMI's (lightweights)!

Good luck with your revision surgery!

Hi there!
I just had my second revison (this time from ERny to DS!). .....  I had chronic diarrhea and am seeing form in my daily bm that I haven't had at all with the Rny.  So everyone's results may vary but I definitely wouldn't let the 90% positive get tainted by the 10% pooping stories you may hear!  Much of that "could" be dettermined by one's common channel length.  Generally, the shorter the CC the more chance of diarrhea issues.  The dude *****vised me from Proxy Rny to Extended Rny only left me with a 20 cc!!!!  Thanks to Dr. K, I am now sporting a healthy 110!

I am THRILLED to be out from under my miserable Rny!!!  I'm not a vetted DS'er so will reserve sharing opinions but the thing I can definitely attest to is that if you have a DS you MUST be committed to a lifetime of consistent and heavy duty supplementation!  Hook up with vitalady.com and she'll help keep you on the healthy path.

Good luck with your revision!  I wish I'd have started with the DS a thousand years ago but I am so grateful that Dr. Keshishian was willing to take my risky case and give me another chance for the golden ticket!  I have an amazing life!  Yet I can't imagine how incredible it could have been if I'd have had your chance to shape my future at 23!!!! 

Take Care!

Thanks for all of the replies. I'm just scared of telling Dr. I that I don't want an RNY. He seems like he's the type of person who makes decisions. I think I can handle pooping. I love pooping lol

How do I go about switching my surgery? Do I call them and tell them that I want a Lap DS instead of a Lap RNY?

It just seems like there is so much maintenance with RNY and I want a better quality of life. I can handle taking my vitamins, that's not a big deal...but I'm afraid of what I all hear about RNY. :(

Leigh,
I'm not familiar with your surgeon.  Does he even do a revision to a DS?  Maybe postpone your announcement to him pending a consult with a DS surgeon.  Are there any surgeon's on the dsfacts.com list that are near you?

None of the 5 surgeon's I had consultations with would consider doing a Revision to a DS so I went out of state to an expert! 

don't worry so much about what the surgeon thinks of you (don't burn bridges if you can help it) and do what you know to be best for yOU!

If you're sincerely interested in the DS lifestyle then how bout posting on the DS forum.  There are oodles and oodles of experts who are kind, supportive and can help field your questions!

Take Care!