DS in Missouri?
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
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.
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.
Have you considered the Duodenal Switch? Information is power.
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.
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 2:12 am, edited 4/11/09 11:23 am - MO
on 4/11/09 2:12 am, edited 4/11/09 11:23 am - 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!
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!
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.
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
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
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A physician from Sedalia, Missouri... Phil Hornbostel |
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Hi! I’m Phil Hornbostel, a surgeon from Sedalia. Watch me on Jeopardy! |
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Season 24 player (2008-03-11). |
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| 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:
"Doubt everything. Find your own light."
-- Last words of Gautama Buddha, in Theravada tradition
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
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