Reactive Hypoglycemia (RH) is the main thing I'm going to talk about from what I've read (I'm not a surgeon, not a doctor, not in the medical field)...
When you get LARGE, you eat more. When you eat more, your body has to process more food, which you needd to eat in order to even maintain your large size. To process more food, your body has to release more insulin into your system to deal with the greater volume of food.
For some folks, the pancreas isn't up to the task, and you get type II diabetes. This is often put into recession by either DS or RNY. The stats are that there is a slightly better results with DS over RNY, but basically if you're someone who has it put in permanent recession by DS and get DS, or by RNY and get RNY it really doesn't matter which one does better, so long as it does better for you. I don't know what makes some RNY patients do better than others. I'm sure there's some correlation between those who had diabetes longer, or whatever. But I have ZERO info on it because I never fit in this category. This subgrouping can get RH, I've heard about it, I don't know how likely it is, but it makes sense that their pancreas hasn't had a pleasant road, so it might not react to massive changes in diet.
For some folks (like me) the pancreas actually grows MORE insulin producing ccells (I read a cool article/study about this) and to my way of thinking, if they could figure out WHY or HOW to stimulate a pancreas to produce more insulin producing cells they could help Type I diabetics to get a more productive pancreas and overcome diabetes. But in any case, for some folks, the pancreass grows more insulin producing cells to deal with the overload of food. When the body loses weight, and needs a lot less insulin, the body is mostly good about toning down the insulin, but a surge of carbs makes the body think "Avalanche of carbs, coming right up, insulin cells, start your engines!!!" and when there isn't enough sugar in the system for the insulin to consume, it drops your blood sugar below acceptable levels and you have a blood sugar crash.
If you are this type of person (like me) I don't believe that I would have escaped RH no matter what TYPE of WLS I had. I'd still have RH, and I know folks who have had the DS (and the VSG and the Band) who have RH. RH is an issue for ANYONE who loses an extreme amount of weight. (as of this morning I'm at 189 pounds below maximum). So having a DS doesn't make it a given that you'll avoid RH. And except for a limited number of folks whose RH is freakishly out of control, most people control the RH with diet. I do. I worry about two planned vacations where my control over food will be limited, and I've done a lot of reading up on low and high-glycemic index foods so that I make smart choices from those available to me (one vacaation is 3 weeks long, that's a long time to be away from my chosen menu, and it's going to cost $5/lb for anything more than 65 lbs I bring with me for the trip, so that is severely limiting.)
The DS is a very powerful, very strong surgery. I always think of it when I think that a person needs to bring the Big Guns in to solve the obesity problem. Realize also that I didn't have it, and my words could easily be taken as biased. YOU need to hear why people are happy with their DS or happy with their RNY and try to figure out based on your knowlege of SELF if one or the other is For YOU or not For YOU.
I've heard some DS people say they dump. I know for a fact only 3 out of every 10 RNY people dump, so dumping should NOT be a consideration (though I hate it, and at times wished I didn't have WLS because I hated the dumping so much, but since I had teh RH, controlling diet for that almost entirely eliminated dumping from my consciousness. I still dump.... I just haven't because that is all down to what i eat)
The DS takes longer in the operating room. It's more malabsorptive. You have to supplement with vitamins for life after either procedure, but can run into severe deficiencies somewhat quicker if you are bad at supplementation and have the DS. My personal opinion (for whatever it's worth) is that the DS is "the big guns" and if your obesity situation is that you have "only" 100 pounds to lose, you might not want to go big guns. Some folks get the VSG (whch is the first half of the DS procedure) and if the restriction isn't enough, they later do the "switch" part of the VSG which makes it into a DS.
When I was making my mind up, I looked at a lot of statistics, and RNY was always going to be my choice. I'm a math teacher so I listened to the "success rates" between RNY and DS and calculated that at surgery day when I had 140 left to lose, I might get about 10% shy of goal compared to DS, and I asked myself if DS was worth it. Were those 14 lbs worth posssible issues with loose stools, exacerbation of GERD, and an extra six month insurance fight to get them to pay for it? Or could I accept that I might not get to goal, cure the GERD, and deal with constipation instead. As a teacher, I didn't want flatulence. I needed the GERD cured, and that was my decision point about ANY WLS in the first place, and I hate fighting bueracracy. It was an 8 month fight just to get RNY, gettin DS.... I didn't want that fight. But that was MY issue, MY body, MY needs.
YOU must decide based on your body.
I personally think one of the best ways of deciding isn't by asking people who had the surgery if they liked it. It's by reading the day-to-day good and bad on each forum, reading the bad is especially enlightening. If people wnat to convince you they focus on the good. But you have to read the BAD on both, and decide which BAD you could handle more..... for some folks the DS near-insistance on having to eat a lot of fat to be healthy.... well that's heaven. For some folks dumping is the biggest incentive to HAVE surgery.
for me, I don't have an investment in your choosing my surgery or DS or VSG (if GERD wasn't an issue, I would have retrospectively chosen VSG). I wouldn't suggest anyone have the LapBand because I've heard too many horror stories about it, and the stats are awful, why would anyone do that to themselves. But YOU have to live in your body, so YOU have to choose.
Good luck making your choice. It's a hard one to choose which alteration to nature you need in order to overcome obesity.
~Lady Lithia~ 200 lbs lost!
March 9, 2011 - Coccygectomy!
I chased my dreams, and my dreams, they caught me!