RNY vs DS

Needing facts and opinions... I started looking into having wls several months ago.  I have done all pre-op requirements of my surgeon.  
At my first consultation with the surgeon, we discussed the different wls options and I explained to him that I am interested in the RNY, mostly because my mother and sister have both had it done with great results and are a great source of "been there" support.
Due to my BMI being 52, he told me to consider the DS as we had plenty of time to decide because of its higher success rate with comorbidites and long term weight loss.
Since then I have done all my pre-op with the RNY in mind, including my nutrition classes and pre and post op nutrition requirements and diets.  Not to mention following this board for RNY, reading online and books about the RNY, and mentally preparing for that surgery.
I received a call from the surgeons office stating that I had been approved for the DS... they had sent it to insurance for the DS, not the RNY.  I explained this to the nurse that called, and she said it would have to be resubmitted.  A few minutes later, she called back and said the surgeon wants to consult with me next week to talk about my options before it is sent back to insurance.
I have a feeling he will want to talk me into the DS, and I don't know what I need to say to him to let him know the RNY is for me.  Does anyone have a good pro/con list that would be of help or anything like that?
He is the only local bariatric surgeon so I am commited to him doing the surgery.
Any advice?

My first question would be, how much experience does he have doing the DS? It is a more complicated surgery. I would also ask if he's going to do it all in one step, or try to get you to do the sleeve part first, as many inexperienced DS surgeons will do. You do have a relatively high BMI, so the DS may be good for you. Both the DS and RNY requirea lifelong commitment to taking supplements. Both have malabsorption. I don't believe the DS post-op eating requirements are as stringent and I don't believe DSers dump (and NOT ALL RNYers dump either).

It's your choice in the end!

He if very experienced in both surgeries and does the DS in one surgery.  It does however, require a 3-5 day stay at the hospital compared to one for the RNY, to ensure you are able to to get in enough liquids and not dehydrate.  I believe he would be good at both surgeries.  I have been to multiple support group meetings and have not heard a bad word about either surgery from anyone.  I guess the biggest problem is I thought I had my mind made up, and now he is making me question what I had decided.

First of all, YOU need to decide, not your surgeon. 

Start with the surgeon and ask him/her to tell you why they feel the DS is better than the RNY for you.  Since he/she does both, you may get some good insight. 

Have you done the same research about the DS as you did the RNY?  Read the books, etc? 

Have you cross posted this on the DS board?

There is plenty of data on the www about the DS and the RNY and I'll bet you could find some comparisons.

Your doctor made some good points already-about your BMI and the success rate.

Help us help you--why do you want the RNY and why are you hesitant about the DS? 

I can tell you my personal decision-I had a BMI of 53.  I did not opt for the DS because it was too malabsorptive and I already have vitamin deficiencies and was scared of that getting into life threatening levels.  I also didn't like the fact that I may have "digestive consequences" if I ate outside the plan (sweets/carbs).  I was not willing to live forever on a mostly protein diet.  I like variety and eat a very balanced diet (the first year it was primarily protein).

Just do your homework and really decide which surgery will give you the best long term results based on your lifestyle.  No surgery is a magic bullet.  Both RNY and DS are great surgeries with pros and cons for each.

Can you tell us why you are thinking the RNY would be a better choice for you?

I felt it was a better choice for me because 1) there were no surgeons near me that performed DS.  2) I live in a small town with no bariatric surgeons and my local hospital does not do WLS at all and if I had to go to the ER for something, I feel certain no one there would have a clue about DS.  They don't know much about RNY, but at least they know a little.  3) the risks of nutritional deficiencies, while pretty high with RNY, are even higher with DS.  I didn't want to have to take even more vitamins.

However, some good things about the DS are: 1) you can take NSAIDS safely.  I really miss NSAIDS!  2) Statistically it does have a higher success rate of resolving things like daibetes, but only slightly higher - RNY does that for most people, too.  3) It does seem more people keep the weight off with DS, or some regain is more likely with RNY.  But many people do keep it off with RNY, too.

In addition to what Kim already said, I just wanted to add that my BMI was 57 and I did not want the DS because I was VERY concerned about the additional vitamin malabsorption and potential  long term nutritional problems (as well as a couple of short term potential side effects), so I chose the RNY.  I was able to lose 185 pounds and have been able to keep it off (I will be 5 years out in August)... and many others have done likewise... so don't let anyone tell you that you "cannot" lose enough weight with the RNY.  It will, however, be easier to KEEP the weight off with the DS.  You have to decide if the nutritional and potential digestive issues are worth the tradeoff.

Lora

Thank you all for your words of wisdom.

My first line of thinking is that my mother (2 years out) and sister (3 years out) both had the RNY with great results and its a huge comfort knowing I have two people handy to rely on for questions and/or suggestions. 

Secondly, when attending the seminar, it seemed that the DS is much more intense and it would be easier for me to screw it up.  I am 100% committed to the process, but it just seemed more "scary".

Thirdly, the longer hospital stay and recovery time would not be good for me.  My husband is disabled and for me to be away from home that long, and to be off work longer would not be good for anyone.

You have some very valid reasons for wanting RNY - discuss these with your surgeon. It sounds like he has your best interest at heart, just may not understand your reasoning. Ultimately, the decision lies with YOU! Best of luck no matter which route you go with!

You have to be comfortable with the choice you make. You may want to ask your doc to explain to you why he suggests DS over RNY for you. 

I had RNY 4 + years ago- and even though I lost all the weight I want and maintain - it is hard or very hard. As many post op RNY - I developed Reactive hypoglycemia (RH).  I still can control that with me diet - but I am on a very restricted diet at this point (eating 5-7 times a day, very limited carbs, no starchy carbs like pasta bread, any grains....) Very limited fruits per day (and only after a meal with fats and proteins) and so on. 
if I know then what I know now - I would choose just sleeve - VSG (it was not an option for me) or DS (I would have to travel - but considering all of what I deal with now - I would).

The first 1-2-3 years - it was not as bad is it is now.  So many people regain after RNY due to the RH... and the way our body processes the carbs.

check this
http://www.dsfacts.com/

Bottom line - any surgery you get - you need to be able to live with - it is so good you are researching...

Sorry for my ignorance on this subject...."Reactive Hypoglycemia".  I have started my 6 mo. diet/exercise program for insurance purposes and have chosen RNY as my surgery type.  I have diabetes due to my weight and wondered if you were diabetic prior to surgery also.  Is there any way they can tell a person will become hypoglycemic after surgery?

Also, does RH make it harder to keep the weight off?  if so, why?  I always thought high blood sugars made it hard to keep weight off???