"lightweight" seeking revision RNY/ DS

I have a story that has been told by many.  Lapband Oct 2006 total loss of 30ish lbs.  and now I am back to my presurgery weight + a few more.  I really shouldn't have had the lapband procedure.  I am diabetic and have high blood pressure.  I should have had a surgery that dealt with my metabolic issues as opposed to just restriction.  I must add that my surgeon at the time only performed lap band and I should have taken that into account because he bashed just about every other surgery.  Ok, what's done is done and I haven't been successful with my band.  I have had reflux issues etc.  I am looking into a revision.  I don't want to go through this a 3rd time, so I would really like to gather all of the information I can to make a decision. 

Currently, I'm looking to have a revision to RNY.  Being that I would be considered a "lightweight", I'm not sure if DS would be "too much" of a surgery for me.  I would like to lose around 100lbs.  I currently weigh 237-240lbs.  I have heard good and bad about both surgeries.  I have read the dsfacts.  I have seen surgery wars.  That is not why I am here.  I would really like some feedback from someone who started out like me.  I am about 5'6 and 240lb.  If you have before and after photos on your profile that would be even better.  I totally agree that DS is a better option, in my opinion, for someone who has more than 100-200+lbs to lose, but I'm not sure if it would be right for someone my size with 100lbs to lose. I will also repost this on the lightweights forum.  I am a mom and of course Im concerned about my quality of life and actually not making things worse with a "surgery gone bad".  I appreciate your input!

Gosh I pretty much wrote your post several months ago. I am 245 this am, and am 5'4" tall. So similar in size too. Untimately I decided on the RNY. I was told that the DS is really for bigger people. I don't have a before and after, as I'm pre op for the RNY.

Good luck making your decision, it's not easy to do.

Teri

You were lied to. I'm living proof that the DS is successful with people with a BMI just barely high enough to qualify for ANY weight loss surgery.

Your BMI is higher than mine was.

It is really a very easy decision to make if you do your homework. All I had to do was write down a list of pros and cons of each surgery. The pro list for the RNY was EMPTY.

i am having my lap band revised to RNY next friday October 8th.  I am on the 10 day pre op liquids which has been very difficult.  Today I weigh 213.  I chose the RNY because my insurance will only pay for lap band or RNY.  A lot of insurances will not pay for the vertical band or the vertical sleeve.  I have blue cross blue shields and they will pay for a vertical sleeve if your BMI is 50 or above or if they get in there and there is a lot of scar tissue and they can't do the RNY.

Because I have extreme heartburn my surgeon has recommended RNY

Tamara

Your surgeon recommend the RNY because he can't do a DS and he used your heartburn as an excuse.

When insurance will pay for a RNY folks have EXCELLENT success getting that insurance to pay for the DS by appeal.

I wish you well with your RNY but I fear you are making a second mistake and a worse mistake. It is much more difficult to revise to a DS from a failed RNY than from a band. I really cringe when I see folks with bands getting revised to RNYs. It is just so so very sad.

I`m sorry the band didn`t work for you. Good that you are now looking into all options.

The DS has the very best resolution of diabetes (studies show a cure rate between 92-100%). The RNY has a resolution rate of approx. 85 %, BUT the problem with the RNY is that the diabetes often comes back after a few years, even when you`re not gaining weight back. There was a study about this published not long ago, you may find it if you ask at the DS board.

The DS is not just for the heavyweights. With 100 pounds to loose, you`re certainly not too small for the DS... remember, even with the DS, the average weight loss is about 70-80%. NOT 100%. The DS can be adjusted to the individual`s needs, which means the sleeve can be made larger and the common channel longer so that you don`t have that much malabsorbation. But revisions generally do worse then first-time patients, which needs to be taken into consideration when the surgeon determines the size of your sleeve and the length of the common channel (if you decided to get the DS).

I would not recommend the RNY to anyone - the only possible advantage over the DS could be if you have GERD, and even with gerd, there are different opinions and experiences out there. There are people whose reflux got way better after the sleeve, too. Apart from reflux, the RNY has only disadvantages and I`d never settle for it just because this is what insurence pays for. Insurence in the US can almost always be forced to pay for the DS if they pay for the RNY.
The biggest problem I see with the RNY is that the regain rate is so high. It just makes no sense to create a pouch out of your stomach tissue and leave the rest in there, producing hunger hormones to drive you crazy. It makes no sense to bypass your pyloric valve and create an artificial stoma. The setup of the RNY is made for failure - the stoma can and too often does stretch, the pouch will stretch too, meaning you`ll always be hungry, and then the RNY gives you just a little malabsorbation which stops about 2-3 years out as your body adjusts. Well, that combined will lead to a major struggle with regain unless you stay on a very strict diet and/or exercise your ass off. If you want it to be like that, go your the RNY.

You can find many more information under www.dsfacts.com

I was considered a lightweight with a BMI of 39.  I had to fight for my DS.  I wanted that 98% chance to get rid of my diabetes.  It did!  I've  lost 65lbs and been stable for 18mo, my A1C was 4.2 on my last lab.  My chol and bp are normal.  I'm in size 9 jeans, L tops.  What's not to like about the DS.  Check out info on dsfacts.com for more info on the DS or come on over to the DS forum.  duodenalswitch.com also has a forum too. 

I hate that the DS is plugged as only suitable for people who are SMO.  It's just not true.  Your surgeon can tailor the surgery to you by adjusting the sizes of your common channel, alimentary limb, biliopancreatic limb and sleeve. 

The day of surgery, my BMI was a 40.3.  I have a 60ml/2oz sleeve with a 150cm alimentary limb and 150cm common channel.  I am not at all too thin.  In fact, I wish my configurations were a little shorter as I never got to my goal!

It's all very individual, but don't get scared off thinking you're going to waste away into nothing if you're a lightweight and you get the DS. 

The DS is too much surgery is just BS spread my surgeons who don't have the skills to do the DS.

I've had both; I had gastric bypass done back in 1980 I was 5'10" and weighed 280, but my weight wasn't the deciding factor as to which surgery to have, there really wasn't any other choice. I was able to lose most of my excess weight with the bypass / RNY but like everyone who has had it for any length of time will tell you, after a year or two, you're on your own and the only way you can maintain the loss is with diet and exercise. It was very difficult, but I did it for about 15 years, I gained a little back, but now a lot and I kept my weight under control by watching what I ate and exercising pretty much every day. I also did ever diet that came down the pike, I even did Fen Phen.

And the thing about gastric bypass / RNY is that you don't have your pyloric valve, so you're susceptible to dumping and food sticking, both maladies I had in spades. In fact those problem add to the difficulty of maintaining the weight loss.

I fought a good fight for 15 years and was what you would call successful, but I lost the war when I got sick and couldn't exercise. Losing the ability to exercise was the end of my weight control and I yo yo dieted and regained my way back to 283 pounds with a BMI of 40.6. I was miserable, I still had the dumping and food sticking issues and I had added hypertension, sleep apnea and gout. I was a mess, but technically just a lightweight.

After struggling with that for 10 or 12 years, I decided I had to do something serious to get my weight under control, I really hated my life as it was then, I had given up doing almost everything I loved to do. I started looking into what my options were and I had no faith in any diet. My local doctors suggested I get a revision to a modern RNY, but when I questioned them about the dumping and food sticking and it that would improve, I was told no, it would probably stay the same. Well no thank you; I had had all the dumping and food sticking I could stand, I wanted my pyloric valve back and I wasn't going to have anything to do with anything like RNY. But I didn't have any idea what I could do, or what was available?

Then I found the OH site and started asking questions and after a couple of weeks of no new ideas, someone suggested I check out the DS forum. I had no idea what a DS was, but I decided to check it out. The more I learned the more I liked, in fact, it seemed too good to be true, but everything I read or heard told me that the DS was the answer. I only took a couple of weeks of reading and researching and I knew I wanted the DS, the problem was that I had a very old and screwed up gastric bypass and the DS surgeons I spoke to were afraid to try and revise me. I was so disappointed and sad, I was in a real funk because I knew what I wanted, but just couldn't find anyone who could fix me.

Then I found Dr. Rabkin; thank God for Dr. Rabkin! After talking to him for 10 minutes I knew he was my surgeon and I scheduled the next opening he had to revise me to DS; it was 12 days away. I had to really hustle to get all the pre-op testing done, but I managed and on Sept 17, 2008 I went into surgery to revise me to DS. That first surgery took 8 1/2 hours, but I was such a mess inside that I had to have a second surgery three days later to fix the rest of the damage from my old bypass and torn stomach. It was some tough times going through all that surgery and the recovery took about two months, but I'm so very pleased and happy I did it.

I've lost the excess weight and I'm eating and living like a naturally thin person does; it is wonderful. It is nothing like the nightmare RNY I lived with for so long. There is just no comparison between the two surgeries, the quality of life and eating with RNY sucks, with the DS it's freedom for guilt about eating for the first time in my life. I love it and there is no way and mean no way in hell I would let anyone turn my stomach into a pouch again.

Why anyone would choose RNY over DS is a complete mystery to me; the only thing I can think of is sheer ignorance. No one who knows and understands the way the two surgeries work and what their life will be like after surgery would pick RNY.

It's your life, so you get to do what ever you choose, but from one who has had both, I'll tell you that RNY sucks rocks and the DS, just rocks!

Kerry

Edit to add; there are a bunch of pictures on my profile if you want to check it out, feel free.

Hi!

If you look at my profile, I think I wrote this word for word !! LOL 

Even as a nurse though, I was not aware of DS out there, but my DR was trying to talk me into a VSG or RNY,  But as I was having issues from the band also decided to do a second opinion, This DR did all 4 WLS.. 4? I was not aware there was a FOURTH !!!

Low and behold I did end up with a DS.

Yes I had only lost 30ish pounds, I was considered a lightweight because I barely had 100 pounds to loose, but the whole reason I did all of this was,, the Diabetes!! and of course the HTN .

In many places they are doing RNY or DS  Just to control Diabetes.  No other reason.

My precursory weight was 251 but I enjoyed eating my way 'up'  the months before, i had stayed around 240 by drinking only protein shakes, because I could not swallow anything else!! so then went to soft foods blended,,,

Both RNY or DS  are major surgeries. Depending on skill level of the REVISION Surgeon you will have recovery time. Choose your REVISION DR. with care...

Like you wanted to Not have to do this again, wanted to just correct and improve my health but live a more normal existence.

Good luck in your research !! PM me if you have any questions!

Debi