Question:
If malabsorption is of such great concern with the duo.switch, can the common tract
be made a little longer? If not, why? I like the upper portion of this surgery better, but am concerned about the distal problems. — Jill C. (posted on February 13, 2000)
February 14, 2000
Oh brother, this is too much. And I can't believe I'm going to respond
but....Really, I have found such ignorance among people on this site when
it comes to the duodenal switch. I've ben in the chat room and nobody even
knows what a biliopancreatic diversion with duodenal switch is (BPD-DS) I
can't believe people say they have thouroughly researched WLS and then say
they've never heard of the DS. This is NOT a put down, just an observation.
I have found that there is a woefully small amount of DS information on
this site but that is wht there are other sites to explore. melanie
actually enthusiastically talks about her surgery and she's accused of the
hard sell. Please, I wish I had a dollar for every person here who has
raved about their,RNY or VBG. The malabsorption component of the DS is very
similar to RNY Distal. Ask any distal if they have higher protein
requirements or are told by their doctors to be monitored a little more
closely. Please, distal means far away and wether that is caused by the BPD
or RNY malabsorption is a component. We all make our decisions regarding
our surgery, and sometimes I have heard of people who want the DS but there
is no local doctor-they either do not want to travel or are unable to
travel for whatever reason, or insurance companies won't pay for a certain
proceedure. PLEASE STOP this senseless arguing. I had the BPD-DS, traveled
from Florida to New York City and am very happy with my choice. I happen to
agree with Melanie that the DS is superior but I respect your decision to
do what you want. ENOUGH!!!!!
— Fran B.
February 14, 2000
I am sorry, but this really has to make me laugh. We are on a WLS
"SUPPORT" site and mocking each others surgery choices. Nice
support, huh? I am certainly not one who has EVER tried to discourage
someone from pursuing the surgery of THEIR choice (oh yes, it is someone's
individual choice isn't it?), but I can't help but get upset at this
bickering. I will encourage anyone to pursue their dreams and not mock
their reasoning. It is not my place and shame on those who think it is.
Yes, I am someone who has chosen the DS. I researched for quite a while
(please feel free to view my profile, there is detailed information there)
Have I EVER told someone that their choice for the RNY, VBG or Fobi was
wrong, or better or worse? Absolutely not! And it sickens me that others
have the gall to do that. We are here to support each other (at least I
thought). And go through experiences of possible life-changing decisions
and emotions. To have someone say that a detailed factual response means
they are "selling" a procedure I certainly don't understand. I
didn't realize Melanie got paid for telling people she is happy with her
DS. I think Melanie shared valid facts in her post along with her
reasoning for her choice. Yes, she said she is happy with her decision,
what's wrong with that? She responded to someone's question. As far as
the NIH, I must conquer that the DS was STARTED back in 1988, let's give it
a chance, advances have even been made in the last five years. The RNY has
been around longer, I'm sure before the RNY, the NIH probably thought that
just "stomach stapling" was the procedure of choice. Do I think
the RNY is a great procedure, yes of course, look at it's success record,
it's phenominal. It has many variables also which changes everyone's
outcome (size of pouch, distal or proximal,etc.). So, what cracks me up
even more is that the "malabsorption" aspect is only mentioned
with the DS, it is there in a distal RNY also. So, to anyone who is
considering weight loss surgery, not those who want to tell someone else
they're making a bad choice, please make sure you look at all options and
make the decision you are comfortable with. Ask lots of questions about
what people like and don't like with each procedure. I'm not going to lie
to you, there are plus's and minus's to each. Yes, they both have post-op
issues to be reckoned with, decide which ones you can live with. And,
please let's dispell the rumor about the DS and the constant gas and
diarreah for the rest of your life, it simply isn't true. As with any
distal (RNY too) yes, you will have more frequent BM's at first but you can
eliminate fatty foods to not deal with this and time will also help, as
with time and eliminating sugars with the RNY as not to dump. Sorry for my
rambling, this just upsets me.
— Christina D.
February 14, 2000
P.S. I wanted to say that I also agree with Fran. I think this is a
wonderful site, I greatly appreciate the response to any questions and
moral support and will gladly offer the same in return. But, I think we
need to have more info on the DS available. Just so everyone knows what
their options are. Remember, there's also www.duodenalswitch.com that has
info on the DS. Thanks for listening
— Christina D.
February 14, 2000
Roberta... I now feel the need to post on this issue. You know...I think
the world needs a whole lot more Melanie Magruders...she is not afraid to
stand up and give an educated answer on this procedure. Sure, what she
says is on the defense. Thats the only way that all of this hokey bullcrap
about the DS is gonna stop. Melanie states FACTS and has PROOF to back up
what she says. I am just so dnag sick and tired of people perpetuating
myths about the DS.
All we are trying to do is educate people and let them know there is an
alternative to other WLS and to stop DS bashing.... i.e. supporting
people!!!!!!!
Jeez.
— Kris S.
February 14, 2000
I would like to say thankyou to all of you that took the time to write and
help me with understanding the difference between the rny and dds. I must
agree with those who say we each must make our own choice because we feel
it is best for us. My biggest worry is that I form keloid scars and am
afraid of them closing off the rny stoma. I like the idea of the stomach
continuing its prior purpose, but worry a bit about the distal. Please try
not to come off as a group of kids fighting about whose toy is best. It is
hard for those of us who are just beginning this journey to sort out the
facts from the sales job. This forum can be of such support to people like
me, but I felt as if I started a war. Thanks again for the help. Jill
— Jill C.
February 14, 2000
Jill...dont feel badly about this. Please dont. I will fight vehemently
about misstatements of facts concerning the DS. This is all a learning
process. You deserve to hear the truth! Never ever feel bad for seeking
it out.
Feel free to call on me anytime. Kris
— Kris S.
February 14, 2000
Ummm... whats a dss surgery? Talk about people not reading. And as I said
previously... I am for education in ALL types of WLS....this means
ACCURATE information. If Jane Doe wants an RNY and she has made and
EDUCATED choice, more power to her... If Joan Doe wants a DS and has done
her research, then more power to her. Most people have never heard of the
DS... and if they dont know about it, then how can they research it? If
people are stating untruths about it... then how can you expect people to
WANT to research it????
— Kris S.
February 14, 2000
Oh ok Roberta...I get it now. You are allowed to say things and when I
come back with the things you say.... I am very bad. You just dont get it,
do you? You never will, I suppose. Thats ok...because with these posts,
we are gonna help at least one person gain perspective. Thats good enough
for me.
— Kris S.
February 14, 2000
This will be my last post concerning this issue. Roberta.. you have a very
accusatory tone that I do not like. You, like others, speak without
facts.
I can tell you that the NIH is wayyyyyyy outdated, and like any other
beauracracy, it will continue to pass out outdated information until it
sees fit to take the time to change it. The DS has undergone many
improvements since this statement from NIH. Just the facts, ma'am.
— Kris S.
February 14, 2000
Roberta - You bring up the NIH and I ask, what did the NIH say was first
choice before the RNY? Could it have been stomach stapling of the 70's?
The DS procedure is one of the newest available. It takes many years to
conduct investigations and statistics for the NIH. Putting that aside, you
keep saying people are "defensive" that's simply not true. We
are simply trying to let people know there are other options out there and
to look at all choices to make an educated decision. We feel as though when
we post, we have to factually back up all we are saying because the DS
tends to get a bad wrap simply because not as many know of it. I by no
means have a problem with anything anyone says on this site, but when you
say people CAN raise caution and we CAN'T "defend" (as you call
it) what was said isn't fair. Your don't see us telling everyone whose
choosing an RNY to be cautious of food getting stuck, having to have
endoscopes done to re-open, do you? There's risks in both, I see though,
only you can tell us, we can't reply. Once again, I want to state how much
I support every decision that people are making. You're in the right place
and I will support any and all decisions you have.
— Christina D.
February 14, 2000
From Roberta - <<You over-react to EVERYTHING! ANYBODY can push your
buttons and control you completely!!! ROFLMAO!!!!!>> If that were
true, we'd have the RNY wouldn't we? But no, we choose to let people know
of other options, why does that bother you so much?
— Christina D.
February 14, 2000
Kudos Fran Gomez! We all have a responsibility to do our homework! This
is our lives we are talking about. I knew after my 'research' that I was
going to have the RNY.
I had my second consultation with Dr Sudan UNMC. he requires that all of
his patients attend an informational meeting. He presents slides and
information (pros and cons) on all surgeries! BPD/DS ?? What was that?
That is NOW my surgery of choice! I am now informed!
I have been soaking up info on this sight for 3 months and still was not
really aware what DS was...It had not been presented to me in an
INFORMATIONAL way. I have since found
the Duodenal sight and am enlightened even more. :)
I cannot get into the chat... so I am certain that I miss out on much of
the hidden nasties... but if the response to this post is any indication, I
don't feel as if I have missed a thing. Every person seeking information
and surgery should be able to ask questions without hesitation.
How are we to become informed if we are not presented with ALL surgery
types. Why should there be segregation?
Differant surgeons will have there preferences and experiences to back that
up... we must still arm ourselves with accurate information to make
choices best for us!
I now know that the BPD/DS is best for me... long term.
— Dottie H.
February 15, 2000
Id like to add my 2 cents to this one *Smiles*..Now I will tell you that I
know very little about the DS, I have researched the RNY more, because
after speaking to my surgeon that is what I am Choosing to go with. But the
bottom line is this....Each of us has a Choice, and Each of us will make a
choice about our surgerys based on our decisons and our own research we
have done, with and without the help of our doctors. Lets Not CUT each
other done, to defend what is your right to begin with. Each us will make
the Decision based on what is RIGHT for us. So who cares if you choose the
DS or the RNY Or anything else out there, if you feel that is the thing
that is right for you , then You do It.....Your the one that has to live
with it..For heaven sakes This is a SUPPORT SITE Isnt it???????? *Grin*
— Ann A.
February 15, 2000
DIFFERENT POINT OF VIEW
Forrest Gump dies and goes to Heaven. He is met at the Pearly Gates by
St.Peter himself. The gates are closed; however, Forrest approaches the
gatekeeper.
St. Peter says, "Well, Forrest, it is certainly good to see you. We
have heard so many good things about you. I must inform you that the
place
is filling up fast and we've been giving an entrance quiz for everyone.
The test is short, but you need to pass it before you can get into
Heaven."
Forrest responds, "It sure is good to be here, St. Peter. I was
looking
forward to this. Nobody ever told me about an entrance exam. Sure
hope the test ain't too hard; Life was a big enough test as it was."
St. Peter goes on, "I know, Forrest, but the test is only 3
questions:
What days of the week begin with the letter 'T'?
How many seconds are there in a year?
What is GOD's first name?"
Forrest goes away to think the questions over. He returns the next day
and goes up to St. Peter to try to answer the exam questions. St. Peter
waves him up and says "Now that you have had a chance to think the
questions over, tell me your answers."
Forrest says, "Well...the 1st one ..how many days of the week begin
with the letter 'T'? Shucks, that one is easy. That'd be...Today and
Tomorrow."
The Saint's eyes opened wide and he exclaimed "Forrest..that is not
what I was thinking, but...you do have a point though, and I guess I
didn't
specify...so I will give you credit for that answer. How about the next
one?...How many seconds in a year?"
"Now that one's harder" says Forrest, "but I thought and
thought about
that and I guess the only answer can be 12."
Astounded! St. Peter says..."12! 12! Forrest, how in Heaven's name
could you come up with 12 seconds in a year?"
Forrest says "Aw...come on, St. Peter...there's gotta be 12: January
second..February second...March second...Apr..."
"Hold it" interrupts St. Peter. "I see where you're going
with it. I
guess I see your point, though that was not quite what I had in mind, but
I'll give you credit for that one too....Let's go on with the next and
final
question.
Can you tell me God's first name?"
Forrest replied, "Andy". When St. Peter asked how in the world he
came
up with the name 'Andy'....Forrest replied, "You know, St. Peter,
that
song we sing in church:...Andy walks with me, Andy talks with me..."
The lesson: THERE IS ALWAYS ANOTHER POINT OF VIEW
and just because another person doesn't see things the same way or
understand the same way that you do, does not mean that it is
wrong............!
— Jill C.
February 26, 2000
What a fascinating discussion! Jill, I understand that you've chosen the
RNY now, and I congratulate you on making the choice after researching the
available options. Not many people ever bother to do that, but rather just
go with what their RNY surgeon says about the alternative procedures (which
they don't perform). I had the DS with Dr. Gary Anthone at USC, and before
I chose I spent MONTHS researching each of the procedures, their long-term
benefits and risks, and the effectiveness of each. There were a few things
in particular that weighed in favor of the DS, which Melanie M. has
explained very well, such as quality of life post-op (we can eat like
little piglets) and elimination of the problems that plague many RNY
post-ops (stoma ulcers, blockages, pouch problems, dumping, etc.). The
reputation for excessive gas and diahrrea that the DS has was a concern,
but those fears were quickly laid to rest by talking to people who'd
actually had the procedure - and I know now from personal experience that
they were right. It's not a problem at all! Another concern was
malabsorbtion - it sounded scary! But in getting educated about WLS, I
learned that malabsorbtion is not a *bad* thing at all - it's what makes
both the DS and the distal RNY the successful procedures they are.
However, I learned that the DS basically eliminates some of the
complications of malabsorbtion, such as calcium and iron deficiencies, and
minimizes protein deficiencies (since one of the enzymes required to absorb
protein is produced in the duodenum, and that portion of the intestine is
moved to the top of the digestive tract in the DS). But the final clincher
for me - the "ace in the hole", so to speak - was the number of
people I talked to whose RNY failed (they regained the weight) and who were
having revisions to the DS. Try as I might, I couldn't find one single
person whose DS failed and were being revised to an RNY. I don't ever,
EVER want to have another surgery for this. Once in a lifetime is plenty
for me, thank you very much. My surgeon, Dr. Anthone, explained the
different procedures available (including the RNY) and told me I was an
excellent candidate for a lap RNY, if I was interested in having one, and
that he would be happy to refer me to an excellent RNY surgeon. He never
tried to "sell" me on the DS, but rather explained why he'd
chosen to perform them over the RNY. All of his reasons confirmed what I'd
learned in my own research, and I chose to have the DS. It's the best
thing I've ever done for myself. If anyone is interested in discussing
this further, please don't hesitate to e-mail me.
— Kim H.
February 26, 2000
With apologies to Jill for cluttering up her inbox, I'd like to lay the NIH
question to rest, if I may. The NIH published it's recommendations on WLS
in the mid-90's. AT THAT TIME, they did NOT address the BPD/DS, but only
the BPD. Now this is significant, because the BPD they considered has since
been revised (and a 21-yr study published by it's inventor) so that it is
no longer the same operation the NIH looked at. And remember, they never
addressed the BPD/DS AT ALL. At the time the NIH published their
recommendations on WLS, which include patient guidelines, they did so over
the objections of the bariatric surgery community, who felt they were too
restrictive. There was not a single bariatric surgeon on the panel. You
might want to keep these facts in mind when posting info about NIH
guidelines. And all of this can easily be verified by reading the NIH
recommendations. My surgeon performs both the RNY and BPD/DS. Which one he
recommends depends on the patient's weight, BMI, lifestyle and other
factors. I chose the BPD/DS after 4 months of research. I'm happy with my
choice, but know it's not right for everyone. Like others who chose it, my
goal is not to sell it, but to correct misinformation, so that everyone can
make an informed choice, based on accurate information about all available
options.
— Duffy H.
February 26, 2000
Oops! I made an error in my post about the NIH. Their position paper on WLS
wasn't released in the mid-90's, but rather in 1991. Dr. Douglas Hess in
Bowling Green, Ohio performed the first BPD/DS in 1988, I believe. Someone
please correct me if I've got this wrong.
— Duffy H.
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