- Username: LeaAnn
- Location: Huntsville, AL, USA
- Member Since: 10/19/2003
- BMI: 26.5
- Surgery Type: Duodenal Switch (11/28/05)
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Surgeon TestimonialGilberto UngsonDr. Ungson is an amazing surgeon with a phenomenal record. He has done some very difficult revision cases and really does a nice DS procedure. The care I received at CIMA hospital in Mexico was outstanding--better care than I would've received in the states. Dr. Ungson is a brilliant and world-class DS surgeon. See my Nov. and Dec. 2005 blog archives to see a LONG list of his patients and links to their profiles where you can read their coments touting the stellar care and treatment they received in Hermosillo, MX. My mother, an RN of 40 years, went with me when I had my surgery in Mexico and was just BLOWN AWAY by how first-class my care was. The hospital is a swanky resort-type place for cash-paying Americanos and upper-class Mexicans. The patients there are treated like royalty. rnrnAn English to Spanish phrase translator pamphlet may be of help in communicating with the nurses, but it was really not a huge problem. Dr. Ungson's nurses and staff were attentive, professional and incredibly competent. I would never hesitate to refer anyone for surgery with Dr. Ungson and his team at CIMA Hospital in Hermosillo, Mexico.rn |
Links to DS Studies 12 hours ago
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Edited to add: http://www.obesityhelp.com/forums/amos/a,messageboard/action ,replies/board_id,4856/cat_id,4456/topic_id,3497583/
Egg Beater Jesus YMCA January 31, 2011 3:01 pm
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Took BC to the must see landmark of Huntsville.
Day 2: SouthEast Regional Atheist Meetup January 30, 2011 10:40 am
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Topic: Daily Atheist Devotional #200 (Local Meetup Day 2 Edition)
Duodenal Switch (11/28/05)
Member Since: 10/19/03
Post Date: 1/30/11 8:42 pm
Last Edit: 1/30/11 8:43 pm
I got my pic in the local paper! hehe! Yup, I'm in this pic. My head is directly in front of the white-headed guy near the middle right.
Sean Faircloth, executive director of Secular Coalition for America speaks at the Southeast Regional Meeting for American Atheists Saturday afternoon at the Holiday Inn Express.
Secular Coalition for America: Legislate for common good -- and mind your own business!
HUNTSVILLE, AL -- The legislative agenda for the Secular Coalition for America can be summed up in one four-word phrase: "Mind your own business," said Sean Faircloth, the coalition's executive director.
Faircloth was addressing those gathered for this weekend's Southeast Regional Atheists Meet, a regional meeting of American Atheists, which continues today, 9 a.m. to 6 p.m. at the Holiday Inn downtown.
He warned that laws based on attempts to regulate one religious view, such as limiting birth control or outlawing gay relationships, not only violate the U.S. Constitution, which was designed to be secular, but also cause harm.
"Our theme is that someone is being hurt; someone's rights are being violated," said Faircloth, drawing the first of several interrupting moments of applause during his talk Saturday.
Faircloth will host a workshop today at 1:30 p.m. about how those forming the Secular Coalition for Alabama, the second state affiliate of the national organization, can become active in influencing laws in Alabama to become religion-neutral.
When religion becomes part of law, everyone loses, Faircloth said. In Alabama, for instance, state laws regulating child care centers are exempted for centers run by religious organizations. Justice, he said, is a moral value those laws trample.
"We want one law for everybody," Faircloth said before his talk Saturday.
On Saturday, he spoke on "Moral Eunuchs: Sex, Morality, Women and Law." Faircloth, who prosecuted child abusers as a former assistant attorney general of Maine. In his 10 years in the Maine legislature, he also championed several bills affecting child welfare and protection. "But those at the top often want to focus on sexual regulation rather than the common good."
The meet, which has drawn 202 registered participants from around the Southeast and other states, included entertainment from actor Paul Provenza, who has written "Satiristas!" Psychologist Dr. Darrel Ray, author of "God Virus: How Religion Infects our Lives and Culture" and "The Performance Culture: Maximizing the Power of Teams," spoke on cultivating teamwork and overcoming leadership "blindspots."
Blair Scott, now communications director for American Atheists and former president of Alabama Atheists, formally handed over leadership of North Alabama Freethought Association to Christie Swords. Scott recalled how the group has grown from his wife and himself in 2003 to about 500 members now.
"A lot of people are coming out of the closet now," said Scott Savage, director of Alabama Atheists and a longtime member of NAFA.
A few Christians from Mississippi gathered across the street from the hotel Saturday morning to hand out Bibles to those attending the conference.
Savage, who spoke with the group for a while, said he was glad to get a copy because he hadn't had one that printed Jesus' words in red.
"From our point of view, the Bible is the best tool we have to convert people to atheism," Savage said.
Today's program includes panel discussions on several issues, Paul Provenza's stand-up routine at 2:30 p.m. Dave Silverman, president of American Atheists is to speak at 3:15 p.m.
My Story When I began looking into WLS and was researching the RNY I was told that the POUCH would stretch over time and I would be able to eat more food. I wanted to know how this would be supportive of keeping the weight off long term. I was told that after a year of eating right that I should be in the habit and stay in that habit. Huh!? I know myself, I love to eat like everyone else, and I will slide back into old habits if I'm able! I clung to that slightly malabsorptive aspect of the RNY thinking that would perhaps help me keep some weight off. Then I read my RNY surgery pamphlet which stated I could expect to keep 50%-65% of my weight off long term. ?!?! I was doing more reading and research trying to see how people fared after doing this to themselves, and that's how I stumbled onto the DS.
The small stomach that is left intact with the DS will stretch back to a normal (but smaller) sized stomach with time. Opponents of the DS argue that the removal of the stomach is a bad thing. In fact, it is not a bad thing--the blind pouch left off to the side with the RNY is a bad thing. This blind pouch is inaccessible to endoscopy evaluation, thus you cannot be diagnosed in the future with problems such as ulcers or tumors, etc. This is why RNYers cannot take NSAIDs because of the potential for ulcer formation in the blind pouch. DS patients can take NSAIDS with no problem.
It is the malabsorptive portion of the DS that results in the superior long-term excess weight lost (around 85%). More of the intestines are bypassed in the DS than the RNY resulting in more malABSORBTION of calories, but NOT more malNURTRITION because of the superior digestion of a fully functional stomach instead of a man-made pouch.
Although the size of the stomach is reduced with this procedure, the
pyloric valve of the stomach, which controls the emptying of food
from the stomach into the intestines, remains in tact. With the RNY
there is a man-made pouch which allows food to pass freely through
the man-made "stoma" from the pouch into the intestines
resulting in dumping syndrome (a potentially-dangerous, sudden jump
in blood-sugar level caused by undigested food entering the
intestines), stomal ulcers, and vitamin deficiency due to poor
digestion. The malabsorption component of the Duodenal Switch as
relates to CALORIES from fat is GREATER than with the RNY because
more of the intestine is bypassed. The DS retains a normal,
functioning stomach with access to all the digestive juices, etc.,
rather than a man-made pouch.
Long-term excess weight lost and kept off is better with the DS.
After the “honeymoon” period of the first year or two of rapid weight
loss ends, 20% (or 1 in 5) of post-op RNY patients gain back 50% or more of
the excess weight lost. The DS combines both restrictive and
malabsorptive elements to achieve and maintain the best reported
percentage of excess weight loss, 80-85% with little or no regain.
The DS surgery without gastric reduction has been
performed on non-obese, diabetic patients since 1997 and is
increasing in popularity in Europe as an IMMEDIATE CURE for type II
diabetes. Latest studies on this technique report a 98% rate of cure.
This is attributed in theory to the malabsorption component of the
DS. The RNY does not cure diabetes. It only puts it in remission, and
the disease oftentimes comes back in two or three years--even if the
patient maintains most of their weight loss. It seems even a small
weight gain long-term (which is the norm) will cause diabetes
Here's a list of careful studies which demonstrate the efficacy and safety of the DS procedure:
· Results of Ten Years or More Post-DS by Dr. Douglas S. Hess (128-138) (preprint which was recently published as "The Biliopancreatic Diversion with the Duodenal Switch: Results Beyond 10 Years," Hess, Douglas S.; Hess, Douglas W.; Oakley, Richard S.; Obesity Surgery, March 2005, vol. 15, no. 3, pp. 408-416(9) which concludes, “...it can be seen that the DS procedure is a safe and extremely effective procedure for weight loss, in fact more effective long-term than the more commonly used Roux-en-Y gastric bypass surgery. It is essentially a cure for Type II diabetes. Other long-term studies have shown little or no serious or irremediable nutritional sequellae, contrary to frequently expressed—but unsubstantiated—concerns. It has been successfully performed in our practice for over ten years, and for several years longer in other practices, and has in our opinion become, if not the “gold standard,” the “platinum standard” for bariatric surgery. It is certainly no longer considered an experimental or investigational procedure, either by the American Society for Bariatric Surgery (ASBS) or by the surgeons who perform it” .
· The Duodenal Switch Operation for the Treatment of Morbid Obesity by Gary J. Anthone, MD; Reginald V. N. Lord, MD; Tom R. DeMeester, MD; Peter F. Crookes, MD (188-189). This study included 701 patients who underwent longitudinal gastrectomy with duodenal switch operation. The mean loss of excess body weight exceeded 65% at five or more years. Perioperative mortality was 1.4% and morbidity was 2.9%. The study concludes, “the ...duodenal switch is a safe and effective primary procedure for the treatment of morbid obesity. It has the advantage of allowing acceptable alimentation with a minimum of side effects while producing and maintaining significant weight loss. These results are achieved without developing significant dietary restrictions or clinical metabolic or nutritional complications” .
· Duodenal Switch: an Effective Therapy for Morbid Obesity—Intermediate Results (190-194): Published in 2001 in Obesity Surgery, this article reflects the intermediate results of Dr. Baltasar’s DS study which has been ongoing and reported for several years. Dr. A. Baltasar is chief of Surgical Service; Surgical Staff; Surgical Resident; at Virgen de los Lirios Hospital, Alcoy, Alicante, Spain: 125 patients were in the study from 1994 to 2000. No patients were lost to follow-up. Dr. Baltasar reports the DS as “the most effective operation to lose weight” (193). He cites a major benefit of the surgery as patient quality of life in that patients can eat virtually all foods and do not suffer the major restriction of the restrictive Roux-en-Y gastric bypass procedure. The weight loss has been consistent with the other studies.
· Biliopancreatic Diversion with a Duodenal Switch (195-216). In 1998, Dr. Hess of Bowling Green, Ohio, published a 10-year follow-up report on the first 440 patients to undergo his BPD/DS proceudre in Obesity Surgery, the leading journal addressing issues related to surgical treatment of morbid obesityh. Generally considered the “father” of the DS operation, having integrated the Scopinary BPD with Dr. DeMeester’s DS procedure, Hess reported his results on 440 patients. The paper outlines many advantages to the DS procedure and states, “this method of surgery has been the most successful for patient weight loss that we have used so far” (216).
· 1998 Scopinaro Report (217-236): The BPD procedure (without the duodenal switch), on which the BPD/DS is based, was first performed in 1976 by Dr. Nicola Scopinaro of Italy. In 1998, Dr. Scopinaro published a 21-year follow-up report on a series of 2241 BPD patients. This report concludes that the BPD is “the most effective procedure for the surgical treatment of obesity” (233).
· Biliopancreatic Diversion with a New Type of Gastrectomy (172): In 1993, Dr. Picard Marceau of Laval, Canada, published a report on the benefits of the BDP/DS procedure over the unmodified BPD. This report confirms that the DS procedure eliminates or greatly minimizes most negative side effects of the original BPD (172).
· Nutritional Markers following Duodenal Switch for Morbid Obesity (567-574): This study was published in the 2004 Jan:14(1):84-90 issue of Obesity Surgery and concludes the the DS “is not associated with broad nutritional deficiencies. Annual laboratory studies, which are required following any type of bariatric operation, appear to be sufficient to identify unfavorable trends. In selected patients, additional iron and calcium supplementation are effective when indicated” (568). This study was submitted to dispute the claim made in BC/BS’s policy that “BPD with or without Duodenal Switch has malabsorptive properties and eventual metabolic complications have been demonstrated” (547). This assertion is simply not true any more for the DS than for the RNY which BC/BS readily covers.
· Comparison of Nutritional Deficiencies after Rouxen-Y Gastric Bypass and after Biliopancreatic Diversion with Roux-en-Y Gastric Bypass (Abstract of a study published in Obesity Surgery in August 2002) (576): This study concludes that there is no significant difference in the incidence of deficiency of the nutritional parameters studied, except for ferritin (37.7% low ferritin levels after RYGBP vs. 15.2% after BPD, P=0.0294). This study was submitted as this was the only DS-related study listed as a reference (263) by the Anthem Blue Cross Blue Shield policy (253-269), which deems there is sufficient evidence to support the BPB/DS (254).
Among the advances of the DS procedure is the absence of dumping syndrome (a potentially-dangerous, sudden jump in blood-sugar level caused by undigested food entering the intestines through a man-made opening), stomal ulcers, and vitamin deficiency commonly seen with the Roux-en-Y (RNY), the compulsory procedure covered by BC/BS of AL (165, 170-237, 267, 559). With the DS, the patient retains their naturally functioning stomach (although the volume is reduced) along with the pyloric valve or natural exit from the stomach to the intestines rather than a problematic, man-made “pouch” as with the RNY (165). Other advantages of the DS are better sustained long-term excess weight loss, a 98 percent cure (181, 183) rate for type II diabetics and ability to take NSAIDs, non-steroidal anti-inflammatory medications. Another advantage still is that the entire stomach and duodenum can be visualized by endoscopy, unlike the RNY which divides the stomach into an upper and lower pouch, the lower of which cannot be visualized endoscopically (165).
Among the advances of the DS procedure are the following:
· Rarity of dumping syndrome (a potentially-dangerous, sudden jump in blood-sugar level caused by undigested food entering the intestines through a man-made opening), commonly seen with the Roux-en-Y (RNY).
· NO stomal ulcers commonly seen with the Roux-en-Y (RNY).
· The DS patient retains their naturally functioning stomach (although the volume is reduced) along with the pyloric valve or natural exit from the stomach to the intestines rather than a problematic, man-made “pouch” as with the RNY.
· Better sustained long-term excess weight loss and, unlike the RNY, a low failure rate.
· A 98 percent cure rate for type II diabetes.
· The ability to take NSAIDs, non-steroidal anti-inflammatory medications.
· The entire stomach and duodenum can be visualized by endoscopy, unlike the RNY which divides the stomach into an upper and lower pouch, the lower of which cannot be visualized via endoscope.
· DS surgery results in little to no nutritional or metabolic complications as long as the supplementation regime (required for any weight loss surgery) is followed carefully.
· DS surgery results in a superior quality of life to RNY in that patients are able to enjoy eating a normal, balanced diet with no specific food restrictions.
· NO stomal plugging and less vomiting.
Here are some disadvantages of the RNY that your RNY surgeon might not tell you about:
· Sugar is not always the cause of dumping
· Many people don't dump at all
· Many people are vitamin deficient because their food intolerances do not allow them a varied diet
· A lot of RNYers drink meat tenderizer mixed with water because food gets "stuck"
· A huge number of diabetics are not cured by RNY, many improve but not many are cured
· About 68% of those with RNY vomit frequently
· Many people gain at least 50% of the weight back
August 21, 2005
Due to impending legal conflicts with my insurance carrier (BC/BS of AL), I have decided to self-pay by going to Dr. Ungson in Mexico!
BEFORE PICS....OCTOBER 2005 (I'm on the left in both photos.) These are from the N AL DS Support Group Luncheon with Ms. Batt (center) and Ms. Natt (right).
November 21, 2005
SO MUCH FOOD, SO LITTLE TIME!!
I think I make love to every meal I have now. I'm trying to think of all my favorite restaurants and fit them in before surgery NEXT WEEK! NEXT WEEK! I've been suffering from "last meal syndrome" for two years now. I went from 39.9 BMI when I started this to 43, probably 44 by now!
We leave for "out West" on Thanksgiving Day. We're (Mom, Hubby and ME) going to fly into Tucson, rent a car and drive up to the Grand Canyon until the 27th, then on the 27th drive down to Hermosillo for my surgery on the 28th. I see so many people saying, "I can't wait, I can't wait!" when talking about their surgery date. Me, I CAN wait!! I mean I'll be glad to have it over with, but I CAN wait!! I'm a nervous wreck!!
SEE ARCHIVES TO SEE HOW THE SURGERY TURNED OUT!!!!!