Question:
Could you explian why you had the DS or the RNY type of surgery.
I am pre-op and am considering which procedure I would like to have. So please explian why you think your procedure is better then the other. I am having my first visit with Dr Peters tomorrow to discuss the different types. I have seen him once already but it was about my gallbladder, which he is removing for me next Wednesday. — barbara0419 (posted on September 9, 2005)
September 9, 2005
My insurance would only cover DS with a BMI of over 50. So I had the RNY
— catmomma3
September 9, 2005
I had the RNY. I don't think it's "better" than the DS, but I do
think it was a good choice for me and so far, so good (at three-plus years
out). I think the best surgery choice type depends on each individual
patient's history, health, and preferences. Pre-op, my perception was that
I'd need to be more careful with my eating habits with the RNY than with
the DS, and I wanted to have to be more careful. Why? I loathed my pre-op
eating habits and knew from previous diets how much better I felt when I
ate healthy (if ONLY I could stick with that, lol). This doesn't mean I
felt I could eat whatever (and however much) I wanted with the DS, or that
I think anyone can, but I did come away with the impression that I'd be
able to "get away with" more with the DS, and with my history
(particularly, the link between my depression and out-of-control eating
habits), I didn't feel that being able to get away with more would be a
good thing. for me. I cannot speak for anyone else on that point. That
doesn't mean I think everybody who has the DS overeats, only that I feel
*I* would have done so with that surgery.<P>I was also concerned
about having more malabsorption than I thought was necessary in my case.
My BMI was 40 *on the nose* on day of surgery. I went way below goal with
just a proximal RNY, and have to do tons of calcium and iron and other
supplementation even with just that amount of malabsorption to keep my
levels normal, so as it turns out, I'm glad I didn't have an even more
malabsorptive surgery in the DS (yep, I know it might be less malabsorptive
in some respects, but you get my general point).<P>I frankly think
the DS may offer a better check against weight regain in the long run.
However, I don't believe any WLS will work in the long run if somebody is
determined to eat around their surgery, including the DS.<P>In
anticipation of some posts you may receive in response to this question,
I'll add that I never once threw up after my RNY, still haven't done that
in three years. I've never "dumped" from eating sugar or
anything else; I gather that most RNYers do dump at least for awhile, but
some never do, so don't count on that either way (as a good or bad thing,
lol). I can eat whatever I want, and I can and do regain if I eat crap (I
just can't eat as much of it as I could before, which is exactly what I
wanted).<P>Good luck with your research.
— Suzy C.
September 9, 2005
If your doctor also does LapBand, you can get info on it as well. DS, RNY,
Band .. all good options for different people. Best of luck to you!
— Jeanie
September 9, 2005
I just more or less answered this question at
http://www.obesityhelp.com/morbidobesity/messageboard/postdetail/1485284.html?vc=0
Do you have to have the gall bladder out right away? Can you wait until
you get your weight loss surgery approved so you can just have one surgery?
I sure hope so -- what a drag to have to go through two surgeries!
— [Deactivated Member]
September 9, 2005
I had RNY (Open) why....because I knew I needed a deterent to sugar and
fats...I love them and they stick to my body! If I have a tool that will
make me sick when I over do them I won't do them. That is why I went the
route I went! I hate to puke so I am careful not to put too much fat or
sugar in my mouth these days. I had an open vs laproscopic because that
was all my hottie surgeon would do...and would you give up a hottie surgeon
for a few small scars....nah! I believe each and every method is good.
Its what you think will work for you. What are your triggers in eating?
Think about them. Read up on all the procedures and see the side effects
and such so that you can make the right decision for you! They all work!
They all work for different reasons too! I am very glad I went RNY route.
DS would allow me to do the sugars and well then my loss would not be what
it is today I am very sure of that!
— dcox94
September 10, 2005
I chose Vertical Sleeve Gastectomy as I did not want the intestinal bypass,
nor did I personally want a forein object in my body and with a 20% removal
rate.
I think the key here is research your surgeon and discuss options with
him/her to determine the best course of surgery for YOU.
Barb
— Barbara V.
September 10, 2005
My decision was made by my insurance, they would only pay for a RNY. The
reason is due to a greater success rate, at least that is what I was told.
Mine was done laproscopically, and I only had 1 pain shot the whole time I
was in the hospital. It has a lot to do with your surgeon. Just curious,
have you ask him about doing both procedures at once???
— Patricia C.
September 11, 2005
This question can get you pretty flaming answers if you post in on the
boards. Let me correct the impression of one poster, a DS can NOT eat
anything they want to and anyone who has this surgery with that idea is
crazy. I chose a BPD/DS becauses 3) I could continue to take medications
that I need to take for depression 2) I have yet to hear of a RNY that
doesn't vomit or get food caught on a regular basis & the #1 reason the
weight-loss retention and is more like 70%. As many as 50% of the RNY's
regain weight. RNY's are forever posting on DS boards asking about
revisions to DS. I have a stomach that holds about 1/2 cup and it will
eventually stretch to hold about the 1/2 size of a regular meal.
Maintaining DS'ers usually eat 3 meals a day with 1 snack. Down sides of
surgery, high risk of mal-absorption of vitamins & minerals, but as
long as one takes vitamins and has annual blood work this should not be a
concern. Instead of vomiting like RNY, DS can be prone to diarreha and gas
but this is usually treatable and food related. Too much fat is going to
cause problems. Some people have trouble with foods varying from milk to
wheat. We have to eat 100 gms of protein and that leaves little room for
carbs and at 8 weeks I have found I can't handle too many grain products
but this may change. Staying away from sugar is not a problem as it
presently tastes terribly sweet and it makes me feel terrible. Also
knowing that I will absorb 100% of the calories from sugar keeps me out it.
After DS absorption rates are approx 100% simple sugars, 30-40% complex
carbs & protein, & 20% of fat. I truely beleive that DS is the
best choice of those of us in the super obease category, but it is a very
major surgery.
— Jenny X.
September 11, 2005
You've received some great advice-- typically, the big debate for people is
between the lap band and the RNY. The DS (and the BPD) are such
specialized surgeries and account for such a small percentage of the total
weight loss surgeries done nationally, that their proponents tend to be a
relatively small minority.
First, in most of the literature that has reviewed long-term success rates,
the DS/BPD is by far the most successful in terms of quick weight loss and
sustained weight loss. Unfortunately, there is a price to be paid for
those benefits-- and the price is that with the re-routing that occurs
during these procedures (which fosters the malabsorption of calories),
there is significant malabsorption of vitamins and minerals. The
nutritional issues are not as easily solved as simply taken daily
supplements and some long-term problems do occur (such as a higher rate of
osteoperosis among men and women who have had DS/BPD surgeries. Secondly,
typically, given the short length of the digestive limb, many DS/BPD
patients do not experience dumping (however, this can vary depending upon
the exact procedure which is performed); consequently, althopugh they
shouldn't, they can (in some instances) eat anything. Of course, given
that you would feel pretty lousy if you weren't maintaining protein, it is
doubtful that anyone would habitually eat unhealthy foods just because they
caused some physical discomfort (not like any of us ever did that when we
were morbidly obese).
The RNY (for me) combined the best of the various weight loss methods by
restricting my intake, slowing the exit of food from my pouch into my
duodenum and imposing upon me the burden of dumping if I overate or ate
sugars. Also, I have found that the proximity of my pouch to my throat
forces me to eat slowly for if food backs up into my throat I will, and
have, gagged.
But, the important thing to keep in mind is to do your own research,
evaluate the risks and benefits of each surgery and then find a surgeon in
whom you have the utmost of confidence. Good luck.
— SteveColarossi
September 11, 2005
No way in H$%l was my ins co going to dictate which weight loss surgery I
would have. If I had cancer and they didn't want to pay for a procedure
that could save my life, I'd fight them all the way. (Which I did, fight
for my DS for over 2 years) I researched the DS, RNY and lapband for 2
years. Read all the peer-reviewed medical literature published in medical
journals. I also have friends from work and church who've had wls, some
rny, others the ds and even one friend who had a gastroplasty 15 years ago.
I wanted to keep my pyloric valve and have a "more normal"
quality of life post op (No marginal ulcers, strictures, dumping, vomiting,
etc.) so I chose the DS. Mis-informed people, including surgeons, keep
saying that there are more vitamin deficiencies and more diarrhea with DS.
Hmmm.. I'm 9 months post op. No diarrhea / No vitamin deficiencies either.
I get my labs done regularly. I only take one prenatal vitamin, a dry A
& D, and 1500 mg of Calcium daily. I get my protein from FOOD, not
protein shakes. I was kinda a liteweight and I've lost 90 lbs so far and
DSers have a weight loss window of up to 24 months. Doc Peters I believe
does both RNY and DS, so he should be able to give you a great comparison
of procedures and help you decide what's best for you! Laurie
— Laurie LOVES her DS
September 11, 2005
I chose the DS. After almost a year of research, mind you! The RNY does
work for some, I just did NOT want the risk of strictures, and having to be
stretched back out cuz the food won't go down. EUWW. Also, didn't want the
weight re-gain that RNY has (almost 50% of those who have it regain).
Some people do like to flame others for their surgery choice, but what good
does it do? NONE! Each person decides for themselves and must live with
that decision.
The malabsorption is greater with DS, but I take my supplements and eat my
protein, so all is WELL. That is what helps the DS folks keep the weight
off! I do NOT have horrendous bathroom issues like some like to say will
happen. Not at all. Fairly back to normal on the potty stuff!
One of the best things about the DS is the fact that the stomach is NORMAL.
It's not a pouch at all! It's actually made smaller for real and the
surgeon keeps the pyloric valve intact (in RNY this isn't the case). Also,
in the DS they remove the part of the tummy that makes the enzyme that
causes the hunger pangs.
My surgeon removed my gall bladder and appendix when he did the DS. All at
once, way to go!!
Good luck in your decision making process.
— T S.
September 12, 2005
I chose DS because is what I wanted, no strictures, pouch issues etc. I am
now over 3years post op. I still was 30 pounds from goal in March of this
year, but got off my butt and watched what I ate, exercised etc. I lost
that 30 pounds by golly! I started out at 335 (super morbidly obese another
reason why I had DS) and I now weigh 155 pounds so a 180 pound loss, no
issues with anything. Very happy!
— Stephanie B.
September 12, 2005
In reading the last post, I can testify about the DS being a potentially
difficult situation to overcome. My best friend had the DS and she did not
comply with high protein low carb diet as prescribed. She lost 100 lbs and
has plataued there for 2 years. She can't put down the sugar and can't
lose her remaining weight. She fluctuates between 200 and 220. She
looks/feels good. But, she is still frustrated b/c she has no motivation
to curb her bad eating habits. In support group the DS'ers talk about the
beauty of being able to eat what they want without consequences (other than
bloating and horrific gas--which by the way having been around it, it will
make you gag and eyes water). So, in respect for the last person who
wrote, I think her view is realistic. For those who want a lot of controls
placed in their lives, the DS is not the way to go. I had the R-n-Y for
the same reasons, and even though I've had to adjust my eating and can't
have whatever I want, I don't regret it for a minute, b/c I no longer feel
ruled by my out-of-control appetite. It's nice for food to take it's
proper place in life--for fuel and nutritional needs, rather than
entertainment. And yes, I've gone through some grieving and sometimes
smells of good, fatty foods drive me nuts. But, knowing that I no longer
have to gorge myself until I'm uncomfortable just b/c I can--that's a
wonderful thing. It takes me all of about 5 minutes to eat now, so I spend
my lunch break walking instead. Feels good to feel great! And the
pay-offs are too many to count! As you make your decision, remember, that
WLS isn't for sissies, no matter which route you take. It is a big
adjustment and there is no way you can know on the front end what it's
going to be like until you do it. BUT, it is worth it and then some.
— billiewallace
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