Question:
WILL YOU SHARE WHY YOUR SURGERY WAS BEST FOR YOU?

I WOULD RATHER NOT HEAR ANY COMPARISONS AND START ANOTHER WAR. IF YOU HAD RNY PROX OR DISTAL, A DUODENAL SWITCH, THE FOBI POUCH VGB OR AGB, PLEASE TELL ME HOW IT WORKS FOR YOU. IF YOU PLEASE, I WOULD LIKE TO HEAR ABOUT ANY COMPLICATIONS AND/OR SIDE EFFECTS FROM YOUR SURGERY. THANK YOU.    — [Anonymous] (posted on August 16, 2000)


August 16, 2000
I AM HAVING THE MINI GASTRIC BYPASS BY DR RUTLEDGE IN DURHAM NC. IT IS A LAP PROCEDURE WITH A VERTICAL POUCH MADE AND THEN THE BYPASS IS DONE WITH ONLY ONE CONNECTION MADE. IT ONLY REQUIRES ONE NIGHT IN THE HOSP AND THE SURGERY IS NOW BEING DONE IN 25-45 MIN. HE HAS VERY GOOD WEIGHT LOSS AND A LOW COMPLICATION RATE. THE COST IS LESS BECAUSE OF A SHORTER HOSPITAL STAY AND LESS TIME IN SURGERY. MOST PEOPLE CAN RETURN BACK TO WORK IN ONE WEEK. SEE HIS WEB SITE http://clos.net It is worth checking out all of your options. people from all over the US come for him to do surgery.
   — Glenda E.

August 16, 2000
I chose the proximal RNY. I had done a lot of research prior to my surgery. My goal has always been to very fit. It's never been to be skinny. I've always admired athletes, not models. I wanted a surgery that would help me make smarter food decisions. I wanted to be able to exercise. I love seeing muscles. Very few people outside of family know that I've had this surgery. When I go out to lunch, everyone just thinks I'm a healthy eater. The change in my quality of life (which will of course mean different things to different people) has been tremendous.) I haven't felt so strong and healthy in a long, long time. It doesn't matter what you decide as long as you pick the right one for YOU. Good luck!
   — Maxine E.

August 16, 2000
I had a Lap proximal RNY done 10/99. I chose this operation after doing my research because I only had 100lbs to lose and I was concerned about long term supplement usage. The first few months were difficult for me, finding what I could eat that wouldn't make me feel mildly ill (I was lactoce intolerant and kept trying to eat things like cottage cheese - before I wised up). It took months before my taste buds returned to normal. I did experience a good deal of hair loss, which started at 4 months and stopped around 9 months. Other than that I have done extremely well. I currently am almost 10 months post-op and can eat almost anything. I eat a normal diet, just small portions and am satisified after a meal. The lactose intolerance is resolving and I do not have problems with eating sugar. I have made my goal weight (this morning I weighed in at 132lbs) and wear a size 8. I am extremely happy with my decision and would do it again in a heart beat. Best of luck to you with your decision.
   — Jilda H.

August 16, 2000
I had a distal RNY 10/94. At the time, I had no "net", so did NO research, as such. I felt lucky to have a doc who did such a thing near me! But I knew two VBG's. My choices were the distal OR VBG. Those I knew were not thin at all and vomited daily. The few distals I met were slender and healthy. Easy choice. Since I was done so long ago, transection was not offered, so eventually, I had a staple line disruption. I got to choose all over again what I would have! I had my revision in January and I chose my same doctor, exact same procedure. I just got a brand shiny new pouch. This time I chose it because, obviously, it had worked for me. Although I was not a sugar eater pre-op, eventually sugar held a great deal of interest for me. I'm glad I dump. I was already lactose intolerant, but no matter as my doc forbids it for maximum wt loss. So, again no loss there. I've held the same wt for years, except that blip on the radar just before my revision. I have more like 18 FEET bypassed. I really did NOT know going in originally how dependent on supplements I would be, but it works well for me since I can be dependent on THEM, rather than food, which I don't completely trust. For my revision, I knew the sort of life I was choosing and did it ANYWAY. My health has never been this good in my entire life, so I would not change a thing.
   — vitalady

August 16, 2000
I had the LGR/DS (longitudinal gastric resection/duodenal switch. Here is how it works for me: since the surgery, I eat just about anything I want, in portions totaling about 1-1.5 cups. I have gas after certain foods, which I have learned to time, i.e., bagels only on the weekend, not when I have to be in the office. I get loose stools, but not uncontrollable, after certain foods, i.e., I ate about 3/4 cup of pistaschios last night, and had a good clean out this morning (which was my goal). Otherwise, my BM's are normal. I get hungry just about as much as I ever did, but it takes much, much less to satisfy me. I have lost 78 pounds in 13 weeks, am riding a bike again after a 14 year hiatus, am able to clean the whole house without having to rest, and am feeling GREAT! I have had absolutely NO complications or side effects from the surgery, and I started out at 494 pounds. I returned to work 1 day short of 4 weeks after surgery, was driving 2 weeks after. I do limit my lifting to no more than 35-40 pounds at this point, but last week, I lifted several bags of cedar chips and gardened for about 5 hours without any difficulty whatsoever. I did do EXACTLY what my doctor ordered me to do and, despite my size, was in very good health prior to surgery (normal blood pressure, normal blood sugar, excellent cardiac and lung capacity, etc.). I hope this helps answer your question. Fondly,
   — merri B.

August 16, 2000

   — Victoria B.

August 17, 2000
I had open RNY 4/10/00, and I'm not really sure whether it's medial or distal. I know, sounds crazy. When I asked my surgeon he just gave me an example - "if the small intestine is 10 feet, we bypass about half." So - take your pick. I do know that it's working. I chose this surgeon and this procedure because it was only 75 miles from my home. I live in ND and was concerned about being geographically isolated if there were problems. I also knew that my PCP worked with my surgeon in follow-up care and that was important to me.
   — Diane S.

August 17, 2000
I made my choice for a proximal laparascopic RNY after extensive research and for a multiplicity of reasons. I am an RN and desired the safest, least invasive procedure available to me...I had had 11 prior surgeries (most of which were major, "open" procedures) and I was not invested in another open procedure if there were other options available...I have a challenging career which, although I had more than enough paid-time-off, I did not wish to be away from for a prolonged recovery period... after a 15 yr. history of irritable bowel syndrome, I did not wish to have a more distal procedure which depends largely on malabsorption as the mechanism for weight loss...and contrary to some individuals who wish to experience no/few changes in their eating lifestyles, I did very much want a surgery which would force me into a healthier way of eating (more slowly, smaller portions, distinctly less fat, stringently limited sugar). My surgery has involved a 2 day hospitalization; no tubes/drains/external sutures or staples; return to full-time work in 8 days; complete resolution of the irritable bowel syndrome immediately post-op; and the adoption of the healthy eating lifestyle which I always wanted, but was never able to maintain. At 5 mos. post-op I have lost 80 lbs. and am completely off all medications (2 diabetic drugs, 2 blood pressure drugs, prescription anti-inflammatory drug and drugs for my GERD). Would I make this exact same choice again?...in a heartbeat. Is this the right choice for you?...only you can choose a procedure that is right for you. My advice is to research the topic thoroughly; don't settle for the first surgeon who offers you the first date; examine your present lifestyle and compare it to the changes that each differing procedure may demand of you; and finally, once you have made your decision, proceed with confidence and faith and never look back and doubt your choice. Each of us who have walked this path believe fervently in our own choices of procedures and surgeons. While all of us on this site should primarily hope and strive to provide unbiased, supportive information, I am sure that we also often present a forum at times which unfortunately may be confusing and frustrating to the pre-op patient struggling to make just the right choice. Remember that the only right choice is the one you ultimately make for yourself. Best of luck to you!
   — Diana T.

September 1, 2000
I too, am from ND (like Dianne S.) and had my surgery in 1995 with Dr. Howell. Open prox RNY. Dr. Howell is (self admitted) very conservative and the procedure is definetly proximal. Most people have 20ft of small intestine. Each side of the top 2 Y limbs are made 5 feet and the remaining tail(common tract) where the food meets digestive juices is made 10 feet. A distal would be with a common tract of 3 to 5 feet.(shorter with BPD/DS, as it is a malabsorbtive procedure) Proximal RNY is ok for some people but it wasn't for me. I have a long history of constipation, which has continued despite surgery, a Distal would have been better for me. (unfortunately I didn't know other options existed then) If you lean toward diarrhea, have crohns or IBS the prox would be better. I don't want to Bag on Dr. Howell's program, however he encouraged me to try experimenting with various food and drinks to see what I could tolerate, and said drink with meals if you want. The only rules were to eat slowly, chew thoroughly, and be aware of sugars and dumping. He also gave me Ensure (first ingredient is sugar) and suggested adding powdered milk to things when he thought I was getting too thin too fast- 1 year post op. The dietician agreed. (he may have made changes since then,I don't know) Since researching WLS I have seen rules on so many web sites: no drinking with meals, no milk, nothing ending in ose, recommend calcium supps. I suppose since he recommended drinking milk didn't think calcium supp was neccesary. The only milk I could tolerate the first year post op had Acidophilus/bifidobacterium added. Dr. Howell makes the pouch between 30 and 45cc,at least in 1995 he did (patients of his look at your White and Green booklet) which stretched to over double in my case, and allows me to eat way too much. Unless you are an exercise fanatic and really watch your diet you will regain and maintain a weight higher than you want. The last time I went to my support group most of the 3 year and over post ops were 45lbs or more than they wanted to be, yet they said they exercise several times a week. There were numerous complaints about being able to eat too much at one time. I had an appt. with Dr. Howell to discuss revisions and asked about stats I found that state most proximal RNY's will maintain a weight loss of only 50% of their excess weight 5 years post op and beyond. He confirmed this as true. If you will be satisfied with keeping off 50% of your excess then this may be the way to go. I am not satisfied with that and regret that I didn't know what I do now. Only knew about VBG and RNY period.(didn't know RNY could be prox or Distal) Some positive things about Dr. Howell is the way he makes the edges of the pouch- he puts a peice of tissue between rows of staples at the edge and sews around it after seperating the pouch from the bypassed stomach. This creates a hard ridge of scar tissue that insures against staple line failure. He also uses cartilidge around the anastomosis instead of foregign material like a silastic band, however this has broken down in some patients (myself included) The key to deciding on the right surgery for you is to look at your eating and exercise behavior and long term goals, ask direct questions. Make a list before your appt. and ask for a longer than average appt. Our clinic only allots 15mn per pt. Which makes getting all questions answered hard. My last 2 appointments I was shoed out prior to getting all my questions answered, but that is clinic politics, (gotta make money) The first 2 years were the best as far as weight loss, I had side effects such as diarrhea if I ate something with high sugar (usually hidden, read lables) or milk based products. I could nibble off my husbands plate and seldom ordered food in restraunts. My appetite and hunger pangs disappeared. Unfortunately they are back and I can't induce diarrhea no matter what I eat or drink. Presently The only reminders I have that I had surgery is being 62 lbs lighter,(which is 50% of excess give or take a few pounds) the big ugly pink scar on my belly, the habit of chewing well and eating slow. Otherwise I have no side effects or problems. Dr. Howell said that the body adapts to any type of surgery within a few years and even if I am revised to a short distal my bowel will increase it's absorbtive capacity over time. That is something to think about when considering types of surgery. No matter what type you decide on take full advantage of your first couple years and make those behavior changes permanent. Find some physical activity (aerobic and strength making) that you enjoy while your at your thinnest and make it a habit. That will give you the best chance at staying at your goal unless you decide to have a more extensive procedure. Look at other patients of your surgeon too. If the long terms look good chances are you will too. Good luck
   — Julie B.




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