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Surgeon Testimonial

Joao Marchesini, M.D.




E-mail: jbmarchesini@hotmail.com

Diplomate of American Board of Surgery

V.P. of Brazilian Society for Bariatric Surgery

Professor of Surgery at Parana University Medical School-Brazil

www.drmarchesini.com


After reading so many glowing reports about Dr M, I thought there was no way he could live up to the hype. I was amazed that he did! He is the most caring, sincere, intelligent doctor I've ever had. Everything about my experience with Dr Marchesini, Brazil and Hospital Santa Cruz could not have been better!

1/21/06 - We are now looking at the self-pay -- unless my attorney can perform a miracle before we leave, we are planning on going to Brazil in April 2006 for surgery.

12/10/05 - Since my first choice surgeon (Dr Snyder) doesn't perform the DS, I'm hoping to go with Dr. Anthone. I haven't met with him but spoke with him on the phone. He was very nice, informative and patient. He called me back after I sent him an e-mail with a few questions. Very nice.
Member Interests
  • Family & Friends - My family is the most important thing to me.
  • Dogs - I have two. My sweet Maltese & a mutt.
  • Running & Jogging - My beautiful daughter is very into cross-country at her HS.
  • Christianity - I love my Lord! He guides my path and opens or closes every door.
  • Hockey - If you can't beat 'em, join 'em! DH & 3 boys play, DH & 1 son are refs.
  • Martial Arts - Started TawKwonDo with the entire family at about 14 weeks post op.
  • Track & Field - My beautiful daughter came || this close to making it to state last year.
  • WLS Light-Weights - Only here would I be considered a 'light weight' - 'just' 105# to lose.
  • WLS in your 40's - I'm smack dab in the middle of it! :)
  • Home School Parents - I love homeschooling my youngest 3 boys.

Latest Surgery Support Comments

  • Comment by ~~~Kaye~~~ G. on 4/21/06 8:43 pm
    Glad to hear that you are home. I'll bet your husband was glad to see you, even if you had to see the doctor. Take care, Kaye G.
  • Comment by swangirl on 4/9/06 2:55 am
    Wishing you all the best on your weightloss journey!
  • Comment by MJ crazy cat lady C. on 4/7/06 12:22 pm
    Lola, your day finally came, yeah ! I am so happy for you and welcome to your new adventure. I am so glad to know you through this board. Weigh to go !!!!!!!!!!!!!!!!!!!! ! mary jean
Click here for the surgery support page


     A study published in the Oct 06 issue of The Annals of Surgery pointed to biliopancreatic diversion with the duodenal switch (BPD/DS) as the most effective type of surgery for morbidly obese patients (with BMI over 50). 

    
 
Dr. Hess' study of 120 patients who had the DS at least ten years earlier, shows 94% were in the satisfactory category, having lost 50% or more of their excess weight. The average excess weight loss at the ten year mark was 76%
(Thanks to Anne S
http://obesityhelp.com/member/zeebs/)

KNOW YOUR SURGERY! 
Comparison Chart:  http://www.lapsf.com/weight-loss-surgeries.html
~~@ Lola @~~'s Blog
My Journey


RNY vs DS - Is it really all in the attitude?
on December 6, 2007 9:24 pm
Hopefully, everyone who has weight loss surgery, makes their choices based on their own personal needs.  The following is a comparative list of statements taken from RNYers and DSers posting why they got the surgery they did.  The worst thing is getting whatever is offered to you and not being fully informed.

I made this list, not to slam anyone's surgery choice but just to point out how differently we can look at the same thing:

RNY - I got the surgery so I'd dump and the fear of that would keep me away from sugar.
DS - I got the surgery so that I wouldn't dump.

RNY - I needed the restriction to correct my relationship with food.
DS - I didn't want the restriction because I want to enjoy my relationship with food.

RNY - I wanted/needed to change my eating habits.
DS - I've dieted my whole life -- I want to quit dieting.

RNY - I'm sick of dieting and failing.
DS - I'm sick of dieting and failing.

RNY - I want a tool that I can work.
DS - I want a surgery that does the work.

RNY - I didn't want to be able to cheat the surgery.
DS - I want to be able to 'cheat' from time to time.

RNY - I want to be healthy.
DS - I want to be healthy.

RNY - I didn't want someone cutting off my stomach.
DS - I don't want a blind stomach.

RNY - I don't want to have to eat massive amounts of food.
DS - I want to be able to eat what I want.

RNY - I needed to change my habits.
DS - I've been trying to change my habits my whole life!

RNY - I never want to eat sugar or fat again!
DS - I don't want sugar and fat to be 'off-limits'.

RNY -- I want the convenience of a close by surgeon.
DS -- I want the convenience of a one-time surgery.

RNY - My insurance would only pay for the RNY.
DS - I fought my insurance long and hard for what I wanted.

RNY - I need to not eat fat because of my high cholesterol.
DS - I need to not absorb fat because of my high cholesterol.

RNY - I didn't want to risk that much malabsorption.
DS - Based on my own diet history, I knew that I needed the added malabsorption to keep off the weight.

RNY - I need help to lose weight.
DS - I'm great at losing weight, what I need is help to keep it off.

RNY:  I know what's best for ME.
DS:  I've seen the revision board, and people don't always choose
what's best the first time.

RNY:  Published, peer-reviewed studies are rhetoric.
DS:  I based my decision on statistics from published, peer-reviewed studies.

RNY:  You can't know anything about a surgery unless you have had that surgery.
DS:  I can know the likely results and complications of a surgery even if I'm pre-op because I did my research.

RNY:  There's no need to put down other types of WLS.
DS:  Statistically the DS is best and comparing and contrasting with the other surgery types is the only way to promote it effectively.

1 comment | Click here to leave a comment.

18 Months and STILL Lovin' my DS!
on October 16, 2007 2:17 pm
I'm 18 months out and still as thrilled as ever about my decision to have the Duodenal Switch.  I lost my 100 pounds in 9 months and I'm now down 105.  My weight is holding steady at about 148 (although I did get down to 143 for a few days after I started on a new medication). 

I started thinking that seeing 139 would be incredible -- although unrealistic.  I can't imagine weighing 139 (I'm 5'8").  My labs are fantastic.  I haven't really had to tweek anything.  My zinc was high at my last labs, but other than that, everything is exactly where it should be for a normal, healthy woman.

I want to say a HUGE thank you to all those on OH who have helped me, encouraged me, rattled me, renegaded me, judged me, inspired me and especially those who have allowed me to inspire them!  Someone here (I'm pretty sure it was Diana Cox) reached out to me on the main board when I was well on my way to an RNY and showed me a better way.  Everyday, I am so thankful.

Life is Good!

Pre-op 253                              18 Months 148

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My Story

I LOVE THIS PLACE! After spending countless hours reading and rereading so many wonderful profiles, I wanted to somehow give something back. I hope that my profile might encourage those who are searching for their own answers in the same way that I was encouraged. I will endeavor to keep my profile updated with regular posts.

I’ve struggled with my weight since I was about 15 years old. Looking back at pictures of myself then… I wonder how I could have been so miserable. I looked perfectly normal. But I was quite miserable. I dreamed of having thin, athletic thighs – not the full, meaty ones I had. Over the last 30 years I have dieted myself to being over 100 pounds overweight! (If you do the math, I’m 45.) With each new miracle diet “success”, I eventually ended up even bigger than before I started. I was always looking for the perfect diet, the perfect pill, the perfect exercise. I have successfully dieted myself to over 250 pounds… sleep apnea, osteoarthritis – hip, knee, foot and back pain; stress incontinence; asthma, gastric reflux, hypertension and elevated cholesterol. Lovely. I have a whole new respect and empathy for those who are SMO. If I am this miserable as a MO person, how much more do others, dealing with even more weight have to suffer?

HOW MY JOURNEY BEGAN

How could I even consider WLS as an option?… Well, it was a strange comment that hit me out of the blue. I saw a woman at my local Curves and she told me, “Oh, I just had weight loss surgery and it’s fantastic! I’ve already lost 50#. You should look into it!”

WHAT? WHO ME???

You have got to be kidding!

That’s for REALLY fat people. (duh)

I was working so hard at getting back in shape and well, it was working again… but I was still quite heavy. BUT WLS? How could she even SAY that to me? When I told my best friend about this little conversation, I thought she’d say “That’s ridiculous.” But no, she didn’t say that. She didn’t say anything. Hmmm.

SWITCHING TO THE DS

When I first started researching WLS as an option, I only thought that there was two choices -- RNY or Band. I consider it a “blessing in disguise” that my insurance denied me for the RNY. It gave me more time to investigate WLS and I found that there is something much better out there -- something that will offer me a 'normal' life. I decided that the surgery I really want is the Duodenal Switch www.duodenalswitch.com . My primary motivation in having the DS is that the last thing I want is to have this surgery fail and end up fat again. I kept reading about people getting revisions, regaining lots – if not ALL of their weight -- lap bands that fail, RNY's that people 'out eat', and end up having to redo! Many of these stories led me to the ‘revision’ of choice for most – the DS. For me, this is my one-time shot. I don't want to have to go through this again. I understand that some people view this surgery as a more “drastic choice” with malabsorption consequences, etc. However, I don’t agree that this is a more extreme choice. It is more difficult to find a competent surgeon. A surgeon has to be willing to be educated, trained and experienced to perform this surgery. It is a more difficult surgery – but the lifestyle for the patient is so much better – I don’t see why anyone would view it as being extreme.


TECHNICAL DESCRIPTION OF THE DS

Gastric Reduction Duodenal Switch - GRDS is a hybrid surgical procedure that has two aspects that reduce weight.

1. The smaller stomach size limits the amount of food that can be taken in to about 120-150cc (1/2-3/4C).
2. The small bowel is reattached in such a fashion as to keep the biliopancreatic juices away from the food until the last portion of the small bowel, enabling limited absorption of the food that is eaten. The hallmark of GRDS is the preservation of the pyloric valve. The pyloric valve is at the last portion of the stomach and acts as a gateway to the small bowel. The food product needs to be of the right chemical and mechanical consistency before the pyloric valve will allow the food product to progress into the small bowel.


MY OWN “WHY DS OVER RNY LIST”

1 – Ability to eat (not overeat) normally after a certain amount of time.
2 – The stomach is bigger and functions more normally. (Go to dinner with a post RNYer and a post DSer and the answer is clear!)
3 – Not having to chew my food to liquid mush before swallowing.
4 – No blind stomach – entire stomach can be scoped, if necessary.
5 – Pyloric valve stays intact.
6 – Entire digestive system is functioning and can – if necessary – be rebuilt; except for lower portion of stomach, which is removed.
7 – DS patients tend to lose a higher percentage of their excess weight. 80-90% excess weight loss – compared to 60-70%.
8 – DS patients keep off that higher portion of excess weight for a much longer time, 10 years +.


Another reason I choose the DS is that I have osteoarthritis and while my weight loss will improve my situation, it won't cure it -- I will STILL need some relief. People with an RNY have little pouch with little stomach acids. There are certain drugs that doctors call "pouch burners" and RNYers aren't allowed any of the NSAIDS.

DSers don't have to worry about NSAIDS. We still have the acids and pepsids and stuff to be able to process those things without causing our stomach to "burn". DSers have a stomach, an intact pyloric valve, and no stoma that goes straight from intestine to "pouch".

Here is the list... I snagged this list elsewhere, it may or may not be complete, but will give you an idea of all the meds that are "off limits" to RNYers.

Advil, Aleve, Amigesic, Anacin, Anaprox, Ansald, Anthra-G, Arthropan, Ascriptin, Aspirin, Asproject, Azolid, Bextra, Bufferin, Butazolidin, Celebrex, Clinorial, Darvon compounds, Disalcid, Dolobid, Erythromycin, Equagesic, Feldene, Fiorinal, Ibuprofin, Indocin, Ketoprofen, Lodine, Meclomen, Midol, Motrin, Nalfon, Naprosyn, Nayer, Orudis, Oruval, Pamprin-IB, Percodan, Ponstel, Rexolate, Tandearil, Tetracycline, Tolecin, Uracel, Vioxx (off market...not safe for anyone), Voltaren

 

I do not believe that the DS is the right surgery for every weight loss patient. I do believe that every WLS patient should be informed and know all their options before they make a decision. I’ve met RNY patients who have never even heard of the DS! I find that sad because it probably means that they don’t know enough about their own tool.

As with any weight loss surgery, the patient has to make a commitment to life-long health. I know that I’ll have to take supplements for the rest of my life. (For years I have taken a handful of pills every day, taking daily supplements for the rest of my life is a given; with or without the surgery.) Patients with the RNY also have malabsorption problems and take supplements. Everyone is different. I have talked to DS patients that don’t have problems and RNYers who do. Each person needs to decide what they can live with.... and what they can't.

 


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