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DS in Missouri?

athena
on 4/8/09 6:08 pm - doniphan, MO
Hi, has anyone here in MO had the DS?  If so who did yours?  Thanks?
Jan C.
on 4/9/09 6:36 am - Cedar Creek, MO
I dont think there is anyone in Mo,. that does the DS.....Closest might be Ok or Tex not really sure.



  http://community.webshots.com/user/mimicook?vhost=community

GOD BLESS YOU TODAY
JAN COOK

LuvCruzn
on 4/9/09 9:56 am - Blue Springs MO
Hey there, I replied to you on the DS board.  Check it out! 

Basically, there's not anyone here in Missouri!  Had one a few years back in Shawnee Mission, but he passed away 1 1/2 years after my surgery.  I'm trying to find someone too, and I think I'm going to Dr. Hustead, he's in KY & TN.  He's a pro on the DS and has a lot of good information.

Keep in touch!
Toni M.

My adivce, do it right the first time and stay with it.  Results - long term success!
emilyherod
on 4/9/09 1:55 pm - Cape Girardeau, MO
What is DS?  I am new to this and I am trying to learn all the code words and initials for stuff.
There is a fantastic Bariatric hospital and weight loss management program in St. Louis call New Start at St. Alexius Hospital.
athena
on 4/9/09 4:12 pm - doniphan, MO
I am new to it as well and am in research mode thus far.  DS stands for 'Duodenal Switch'.  I can't tell you all about it off the cuff, but if you type ds in the search bar, it should point you in the right direction, that's where I found my info.  As far as I can tell from my research, St Alexius does not do the DS.
Guate Wife
on 4/10/09 12:29 am - Grand Rapids, MI
DS on 12/13/07 with
For one of the best sources of information on the DS, which will include long-term, peer reviewed, clinical studies, please check out DSFacts.com.  There you will get not only find factual data on the DS, but also true insight into the post-op DS life.

       ~ I am the proud wife of a Guatemalan, but most people call me Kimberley
Highest Known Weight  =  370#  /  59.7 bmi  @  5'6"

Current Weight  =  168#  /  26.4 bmi  :  fluctuates 5# either way  @  5'7"  /  more than 90% EWL
Normal BMI (24.9)  =  159#:  would have to compromise my muscle mass to get here without plastics, so this is not a goal.


I   my DS.    Don't go into WLS without knowing ALL of your options:  DSFacts.com

Bostel
on 4/9/09 7:40 pm
Since you asked, here's the quick answer on Biliopancreatic diversion/duodenal switch.  The operation was devised in Italy by a surgeon named Scopinaro (who is still active in bariatric surgery).  It is touted as the most effective in terms of total weight loss, BUT it also carries the highest risk of complications, both short-term and long-term.  Patients are prone to liver failure and renal failure up to ten years after duodenal switch, and the likelihood of developing iron deficiency and vitamin deficiencies is significant.  These patients should have blood testing every 3-6 months on a PERMANENT basis to ensure their tolerance to this relatively severe change in intestinal function.  And while patients like the sound of "being able to eat more", this is tempered by the fact that if they do continue to binge on processed carbs long-term, they develop a distinct aroma reminiscent of a Missouri outhouse.  In truth, the operation generally is reserved for patient who weigh at least 550 pounds; this operation is the ONLY chance these patients realistically have to achieve anywhere close to normal weight.  BUT, for the typical patient with morbid obesity who weighs less than 450 pounds, the gastric bypass has a much higher safety profile, and is almost as effective.  This is also why the duodenal switch is only offered at a few select sites in the US; NONE in Missouri.  Nearest is Chicago.  I tell patients who are determined to have a duodenal switch that they seriously need to plan on MOVING to the city where they have their operation, to ensure long-term followup.  Hope this helps!  Best wishes!  Sincerely, Phillip M. Hornbostel, M.D.
Kerry J.
on 4/9/09 8:37 pm - Santa Clara, UT
 Dear Dr. Hornbostel M.D. 

You are full of crap. Shame on you for posting such a load of BS on this board. What you are describing is not a DS, it's an early procedure named after Dr. Scopinaro. This procedure hasn't been done for a very long time because of the problems you describe. 

I suppose you're one of the RNY mill doctors, so you don't want people to really find out about the DS, because when they do, you have no chance of collecting any fees for your RNY work.

I lived with RNY for 28 years and it sucks, I was revised to DS last year and it's great, I've never felt better and only wish I had done the revision 10 years ago.

You are a disgrace, you lying sack.

Kerry Johnson
Redhaired
on 4/9/09 8:38 pm - Mouseville, FL
DS on 07/13/06 with
There are numerous studies that document the DS is a safe and effective surgery for those with lower BMIs.  As to the aroma as you put it, that is just simply not true.  Oh, and the Scopinaro procedue is the biliopancratic diversion (BPD) not the biliopancreatic diversion with duodenal switch (BPD/DS).  These are two very different surgeries.  The Scopinaro procedure is rarely done anymore because it caused so many issues. 

Red

  

 

 

JennType1
on 4/9/09 9:13 pm - Middle of, TN
You know, this post is simply disgraceful. You would rather spew outright lies to potential patients than paint the surgery you do, the RNY, in its best light. The DS is not reserved for people with a 70+ BMI, far from it. There is no statistical difference in surgery survival rates between RNY and DS. Or are you simply so ill-informed that you have never read these peer-reviewed articles:

Marceau et al 2007
Conclusion: Survival rate was 92% after DS. The risk of death (Excess Hazard Ratio (EHR)) was 1.2, almost that of the general population. After a mean of 7.3 years (range 2-15), 92% of patients with an initial BMI < or = 50 kg/m2 obtained a BMI < 35 and 83% of those with an initial BMI > 50 obtained a BMI < 40.

The Biliopancreatic Diversion with the Duodenal Switch: Results Beyond 10 Years.
Hess et al. Mar 2005
PubMed Abstract

The BPD/DS, if properly performed, has the best long-term weight loss of any bariatric operation. It is easy to reverse or revise, has the least marginal ulcers, cures the highest percentage of co-morbidities, has the least failures, and permits normal although smaller meals. It is our opinion that the BPD/DS should be considered as the gold standard bariatric operation.

Bowel Habits after Gastric Bypass Versus the Duodenal Switch Operation.
Wasserberg et al. Aug 2008
http://www.ncbi.nlm.nih.gov/pubmed/18752029

BACKGROUND: One of the perceived disadvantages of the biliopancreatic diversion with duodenal switch operation is diarrhea. The aim of this study was to compare the bowel habits of patients after duodenal switch operation or Roux-en-Y gastric bypass.

RESULTS: The duodenal switch group was heavier (body mass index 53.5 vs 47.0 kg/m(2), p = 0.03) and older (47.5 vs 41.0 years, p = NS) than the gastric bypass group. Median time to 50% excess body weight loss was 22 months in the duodenal switch group compared to 10.0 months in the gastric bypass group (p = 0.001). Patients after duodenal switch surgery reported a median of 23.5 bowel episodes over the 14-day study period compared to 16.5 in the gastric bypass group (p = NS). There was no between-group differences in any of the other bowel parameters studied.

CONCLUSIONS: Although duodenal switch is associated with more bowel episodes than gastric bypass, the difference is not statistically significant. Bowel habits are similar in patients who achieve 50% estimated body weight loss with duodenal switch surgery or gastric bypass.

Copies or links to of all these studies (and many more) can be found at www.dsfacts.com, a website developed by a DSer who is not affiliated with any medical provider of any kind.

ANd for newbies to the idea of the DS, yes, you absolutely must commit to supplementation and regular labs. To me, that's a small price to pay for a surgery that, unlike the RNY, allows me to take ibuprofen if I have cramps. to avoid dumping, and to not worry about food getting stuck in a stoma and having to barf it back up. RNYers need regular labs, too, and have their own issues with vit. B-12 deficiencies.
 
I'm not saying that one surgery is better than another, but I am horrified that an MD who absolutely knows better is getting on here and trying to deceive patients and potential patients. I really hope someone decides to report you to an ethics board, doctor. What you posted is unconsionable.

 

Jenn
Type 1 diabetic, 26 years
With great power (the DS!) comes great responsibility.

  
KRWaters
on 4/9/09 10:14 pm - Manteca, CA
Dear Dr. Hornbostel,  I think you should read up on the current DS as it is done now, not the BPD with no DS. That is an old version and is no longer done. That's where you docs get all your wrong information. Read www.dsfacts.com  and read www.duodenalswitch.com. I think every RnY doctor should read those sites. It is too bad that the current DS was named DS, and that is where all the confusion lies. Pity, pity, pity. That is why so many people in need of an excellent WL:S are not getting one because of docs like you badmouthing a very good thing.

KAREN W. 


I LOVE MY DS!!!!!

STRIVE TO BE THE BEST YOU CAN BE AND DO THE BEST THAT YOU CAN.


Check out
www.dsfacts.com  and www.duodenalswitch.com
 for all the accurate information on the great DS, and find surgeons in your area or around the country or out of the country.

I couldn't have done without all the great peeps on this board.

SW: 234.5     CW: 157   GW: 140 - ish 

 

Kathy H.
on 4/9/09 10:47 pm, edited 4/9/09 10:47 pm - Kent, WA
DS on 05/04/09 with
It's clear you've either failed to research the current DS surgery, or you have... and decided to fabricate negativisms in order to pump up your RNY client base.

Either way, it's at best despicable ... and at worst, unethical.

It's posts like these that turn a mild-mannered gentleman like Kerry into a rabid, flesh-eating twisted pit bull on crack. And it's why DSers are so quick to jump to the defensive.

MOVE to another town because you choose to have the DS?? Are you nuts? For lab work? What backwater town do you live in that can't perform a simple (albeit lengthy) set of labs on someone every six months?

Read up and stop spewing falsehoods.
-----------------------------------------------------------------------------------------------
Have you considered the Duodenal Switch? Information is power.




(deactivated member)
on 4/9/09 11:51 pm - San Jose, CA
Are you that unethically misinformed as a so-called medical professional, or just unethically trying to dissuade people from having a SUPERIOR surgery that you are unable to perform?

Your post is nothing but flat-out disinformation.  Long term results are actually showing RNY as having the worst outcomes in terms of malnutrition.  DSers are NOT "prone to liver failure and renal failure up to ten years after" the DS -- WHERE ARE YOU GETTING YOUR SO-CALLED "FACTS?"  Iron deficiency?  Less likely with the DS than with the RNY.  Vitamin deficiencies?  If you don't take your supplement, sure -- but if you aren't willing to take vitamins, you have no business having the DS -- OR THE RNY.  Blood testing every 3-6 months?  What are you smoking?  If your blood work is OK, then once a year is sufficient -- you only need more frequent testing if you are adjusting the level of something -- just like you would if you were getting thyroxine or coumadin or some other medication levels correct, for cripe's sake.

Even if a DSer overindulges in processed carbs (which of course nobody should do) the smell is in the poop or farts -- not oozing out of the body through the pores.  Your exaggeration and hyperbole is shameful.

The DS is NOT "generally reserved for patient [sic: you have problems with the English language too?] who weigh at least 550 pounds" -- you are simply lying out your ass on this one.  The DS is ROUTINELY performed by surgeons who have the requisite skills (which you obviously don't) on lightweights, including those with BMIs of 35-40.  In fact, it is one of the most versatile of the bariatric procedures, because the stomach size, common channel length and total alimentary tract length can all be tailored to the patient's weight, height, age, comorbidities (e.g., type 2 diabetes) and other factors.  You're just full of disinformation, aren't you?  And I'd say it stinks worse than a DSers ****

Your statement that for patients less than 450 lbs, the RNY has a "much higher safety profile" than the DS is a complete fabrication -- PROVE THIS WITH PUBLISHED DATA!  I already know you can't -- I know the literature due to my pro bono work helping people fight their insurance companies for the DS.  "Almost as effective" -- that's just laughable.

The reason the DS is only offered at a few places in the US is BECAUSE OF MONEY -- RNY mills like the one you likely work at are willing to contract with insurance companies to drive down prices of a cheaper and easier surgery that can be done 5 a day, at the expense of the more difficult (for the surgeon) DS procedure, which at best can only be done 2 per day by a competent DS surgeon.  Most DS surgeons refuse to contract with insurance companies so they won't be forced to compete with the prices of the RNY mills.  Also, the RNY can be learned by a general surgeon quite easily, while it is my understanding that the DS requires that a surgeon take some TIME (weeks if not months) to proctor with an experienced DS surgeon -- which most money-grubbing surgeons aren't willing to take the time and pay cut to do.

Finally, if you are SO misinformed and disrespectful of the truth that you don't know this, the MO surgeon Dr. Sifers was a despicable human being who CLAIMED to be doing the DS on people, but it turned out he was doing the biliopancreatic diversion, which is COMPLETELY different and a discredited procedure.  He died with malpractice suits pending against him.  http://www.pitch.com/2005-03-31/news/the-final-operation/  The problems his former patients are still having are because he gave them some other surgery.

Your post is a disgrace.
(deactivated member)
on 4/11/09 9:12 am, edited 4/11/09 6:23 pm - MO
OMG!  I am SO thrilled to see the DSers on the Missouri board!   Good God it's an answer to a prayer!  I am so very regretful of my RNY, and so wish I had the DS!  But every time I try to say anything here I get shot down!

W E L C O M E      DSers to the Missouri Board!  I *heart* you all!

PS  Diana, you SAVED my life with your advice on probiotics for gas.  Thank you SO much!
Elizabeth N.
on 4/11/09 5:33 pm - Burlington County, NJ
Well, come hang out on the DS board and quit wasting time here then :-).
Amy Farrah Fowler
on 4/12/09 2:50 pm
I'm sorry you have surgery regrets, but I agree you should check out the DS board. There are people who have had other surgeries that post there, and I think it's one of the best boards on OH for the give and take of good information.
"Just Elizabeth "
on 4/9/09 11:54 pm - Houston, TX
You are so full of **** I almost do not know where to start. As you would much rather speak out of your ass having only partial data on a separate procedure I would like to address several of the statements you made.

BUT it also carries the highest risk of complications, both short-term and long-term.

Please state where you are getting these "facts" from. I have never seen a peer reviewed study that said this. If you have actual proven data to back this up I will be happy to give you your due on this.

Patients are prone to liver failure and renal failure up to ten years after duodenal switch, and the likelihood of developing iron deficiency and vitamin deficiencies is significant.

Again, please provide the studies that back this up. I will give you that there is the CHANCE of deficiencies IF the patient is not compliant with the vitamins required and does not take the lead by looking for downward trends in your blood work instead of just letting the doctor get away with "It looks fine."

These patients should have blood testing every 3-6 months on a PERMANENT basis to ensure their tolerance to this relatively severe change in intestinal function. 

Well you are partially right. They should have their blood work done every 3 months FOR THE FIRST YEAR. But I believe that is the same for people who have had the RNY. The only time after that first year that you would need blood work more frequently than once a year is if there is a downward trend and you are monitoring it until it gets back into the normal range. Then you can go back to once a year. I believe that this is also the same for people who have had the RNY.

And while patients like the sound of "being able to eat more", this is tempered by the fact that if they do continue to binge on processed carbs long-term, they develop a distinct aroma reminiscent of a Missouri outhouse. 

This is flat out, incorrect. Usually the people who spout these falsehoods are doctors that want to steer patients away from a procedure that might be better for them because they can not do it and thus they would not make any money on it or the patients that have been told this bull**** by, IMO, those incompetent or shyster doctors.

Do carbs give us gas? Absolutely. But it is something that can be easily controlled by what we eat. Eliminate that carb, eliminate the gas. However, a lot of these carbs give non-op people terrible gas as well. For example: beans.

I do not know of any DSer that has an "odor" as you put it and I have met people who have had this procedure from all over the world.

In truth, the operation generally is reserved for patient who weigh at least 550 pounds; this operation is the ONLY chance these patients realistically have to achieve anywhere close to normal weight. 

Wow! I must have been able to fool the whole medical community into thinking I was much larger than I was as I had the procedure when I only weighed 320 pounds and I had no comorbidities. 

This is another incorrect statement. People who are considered WLS lightweights can and do have this procedure safely. And they do live normal lives after the fact.

BUT, for the typical patient with morbid obesity who weighs less than 450 pounds, the gastric bypass has a much higher safety profile, and is almost as effective. 

Really? I would love to see the scientific data to back this up. Scientific studies have shown that the DS tends to have better long term results in keeping EWL off. So if you have a scientific study that counters this, please post it.

This is also why the duodenal switch is only offered at a few select sites in the US

Actually that is NOT the reason that it is not done as often in the US as the RNY. The reason is money. It takes longer to do a DS than it takes to do an RNY. Typically the doctor can do 3 RNYs in the same time period that it takes to do 1 DS. Also, the training requirements for the DS are much harder than with the RNY.

I tell patients who are determined to have a duodenal switch that they seriously need to plan on MOVING to the city where they have their operation, to ensure long-term followup. 

In my opinion, this is a useless piece of advise, at best. The majority of people who have the DS are extremely knowledgeable of the procedure. We have to be. Half the time we are educating the doctors. Learn all you can and train your doctor in what you need. If they can not, or are not willing to, learn what you need to have in your aftercare then find one that will. You must take the reigns in your own health care.


Elizabeth                                                      
Back in the U.S.A.


"I have lost the lumbering hulk that I once was.  I don't hide behind my clothes or behind my door.  I am part of life's rich tapestry not an observer."  Kirmy

        
                                                                                    
 

Guate Wife
on 4/10/09 12:37 am - Grand Rapids, MI
DS on 12/13/07 with

Wow.  Are you that desperate for business that you actually LIE to people in an attempt to drum up business?  You have simply proven how completely incompetent you are as a medical care provider by providing this factually incorrect information.  Someone should really strip you of your medical license for being unethical at best, and a complete idiot when it comes to knowing what the hell you are talking about in regards to bariatric medicine at worst.  I wouldn't trust you with knowing what to do for a sinus infection, let alone perform surgery on me.

       ~ I am the proud wife of a Guatemalan, but most people call me Kimberley
Highest Known Weight  =  370#  /  59.7 bmi  @  5'6"

Current Weight  =  168#  /  26.4 bmi  :  fluctuates 5# either way  @  5'7"  /  more than 90% EWL
Normal BMI (24.9)  =  159#:  would have to compromise my muscle mass to get here without plastics, so this is not a goal.


I   my DS.    Don't go into WLS without knowing ALL of your options:  DSFacts.com

FastFingers ~*~
on 4/10/09 7:57 am, edited 4/10/09 9:31 am

A physician from Sedalia, Missouri...

Phil Hornbostel

Hi! I’m Phil Hornbostel, a surgeon from Sedalia. Watch me on Jeopardy!

Season 24 player (2008-03-11).

Won $1,000 on Who Wants to Be a Millionaire on 2000-10-26.

Phil appeared in the following archived game:
#5417, aired 2008-03-11 Jeff Harmon vs. Jason Kaczor vs. Phil Hornbostel



ETA:  I don't know about you folks, but I could see the original photos when I first posted them, but I can't now.  So I'm adding this one:


                                   Flying Spagetti Monster

"Doubt everything.  Find your own light."
--
Last words of Gautama Buddha, in Theravada tradition

"Just Elizabeth "
on 4/10/09 9:01 am - Houston, TX
OH DEAR FSM!!!! Amy you are the best!!!! So to answer the above asked question, yes apparently he is that hard up for money.


Elizabeth                                                      
Back in the U.S.A.


"I have lost the lumbering hulk that I once was.  I don't hide behind my clothes or behind my door.  I am part of life's rich tapestry not an observer."  Kirmy