Question:
RNY vs DS

Many of you did your homework prior to your surgery. I'm booked for RNY Lap this month but am wondering if DS is better? Any support would be much appreciated! Thanks    — Miera (posted on December 10, 2005)

December 10, 2005
My RNY saved my life as it helped me to lose over 300 pounds and sustain not simply a healthy weight, but also a healthier relationship with food than I had ever imagined. But, just because having an RNY was the right choice for me, doesn't mean that the DS is not the right choice for very many others. Both operations require lifelong vigilence for nutrition--- with the RNY, you just can't eat enough not to be cognizant of your nutritional needs (and the need to supplement) and with the DS, your body is re-designed to not fully absorb the calories and carbohyrdates (and, consequently, the vitamins and minerals) you ingest. So, with the DS there is a greater risk of nutritional deficiencies and issues associated with those deficiencies (like osteoperosis). With the RNY there may be foods which you will never be able to eat (even after more than 3 years out, I still can't eat sweets and have considerable limits on the amount of food I can eat), which does not seem to be an issue for DS patients. With the RNY there is always a risk that you can "eat-through" your procedure (basically by ignoring the discomfort and pain that would come from overeating), but with the DS, there is not that risk. However, with the DS there will be periods of very frequent bowel movements and, for a fair number of patients, an issue with bowel/flautulence odor. The bottom line (no pun intended) is that both surgeries provide long-term success for those who suffer from obesity-- the DS carries with it some greater risks, but studies indicate that DS patients will, in fact, lose a greater percentage of their excess weight and keep it off longer. For me, however, in balancing the risks with the benefits I knew I could achieve from an RNY, I choose the RNY. Regardless of the surgical weight loss method you choose, know that there will be changes that will last a lifetime. Good luck in making the choice that is best for you.
   — SteveColarossi

December 10, 2005
With the DS, there is a greater chance of odors and diarrhea, but you can control them with your food choices (I eat pizza for dinner but not for lunch on a work day), and in almost all cases, the loose stools can be controled by diet, fiber and making sure a bacterial overgrowth doesn't get established, by taking probiotics and for some people, occasionally doing a round of antibiotics to kill off the bad bacteria and re-establish the good ones with the probiotics. Malnutrition issues, if any, can be detected early by being vigilant with yearly blood work and adding supplements if necessary. I'm two years, 4 months out, and I take one prenatal vitamin per day and four calcium citrates (I eat a lot of dairy and my calcium levels are excellent). I have no issues with protein malnutrition (I eat a LOT of yummy protein every day, very easily, because NONE of it makes me ill, ever -- nothing ever gets stuck because with the DS there is no stoma), don't dump, and the issues of getting stinky gas with eating processed flour (white bread and pasta in particular) help me keep my consumption of those to a relative minimum -- however, if I WANT them, I have them. For quality of life long term, and stability of weight lost long term, including maintenance of the CURE for diabetes over 10 years (98% cure rate), the DS is my choice.
   — [Deactivated Member]

December 10, 2005
I had originally set my mind on DS. The largest problem with this, although it works wonders for many, is it causes farther disturbance in absorption, as well as long term foul smelling gas and loose stool. For some this problem does eventualy lessen , but for many is a lifelong struggle. It also has more problems with vitamin deficincies. I researched all manners of surgery well, by reading and talking to post-op patients and speaking to many health care professionals, and decided upon RNY-distal. Most insurance companies will not pay for anything but RNY willingly as well, they consider it experimental as far as WLS goes. The only advice I can offer you is ask, research, ask again and decide with the help of your doctor which is best for you. Good luck...mine is this month , nervous and excited..but well informed. XOX ally
   — allyson1211

December 10, 2005
Just to clarify some misconceptions: Studies indicate that type II diabetes is essentially cured by both surgeries-- not simply the DS. Although with both surgeries vitamin and mineral deficiencies can be caught by annual bloodworkd, fixing them for the DS patient is not as simple in all circumstances as taking a single vitamin. Lastly the issue of dumping (the process where eating too much too much or trying to process refined sugars causes discomfort) is not a negative for the RNY patient as it is an intended consequence-- it is a part of the negative conditioning that the RNY promotes in helping patients avoid traditional trigger foods and bad eating behaviors that are responsible for considerable weigt loss. As many RNY patients discover, we suffered from a food problem as well as a weight problem-- so having a surgical method by which certain foods must be avoided is not depriving us of anything, rather it is giving us a second chance for some health. This all being said, and despite the advantages I believed the RNY offered me (my surgeon actually performs both the RNY and the DS), there is no escaping the higher excess body weight loss and the longer-term sustainability of that lower weight for the typical DS patient.
   — SteveColarossi

December 11, 2005
Rachelle, Of course, this is a highly personal decision. A lot of people find insurance companies, uneducated health care personnel, and simple lack of fundamental information as the major components that steer a person toward one surgery or another. The bottom line comes down to the fact that we ALL (regardless of which surgery we choose) are ultimately for the decision we make whether or not to go forward to surgery, which surgery is best for us, which surgeon we will choose, and what kind of post-op lifestyle requirements we're going to incorporate into our lives. There are some really great resources for learning more about the various surgeries offered. Here are some that I found to be helpful when I wanted to know more about the DS: http://www.gr-ds.com/generalinformation/comparison.html http://www.obesityhelp.com/morbidobesity/m-surgerytypes.phtml http://www.asbs.org/ http://www.johnhustedmd.com/switch.htm http://www.duodenalswitch.com/ http://www.pacificsurgery.com/ http://www.dshess.com/ http://www.drbaltasar.com/i_default.html I'm biased - I love my DS! I love the quality of life I enjoy, I love the fact that I've lost 210 pounds effortlessly, I love the restored health that I have. So, keep my bias in mind! LOL! I had my surgery with Dr. Aniceto Baltasar in Alcoy, Spain just shy of 3.5 years ago. (My husband also had surgery with Dr. Baltasar almost 1.5 years ago, as well.) It was the best decision I think I've ever made in my life. I thank God daily for letting my insurance company deny my pursuit of surgery and leading me to Dr. B - he's the coolest, an incredibly gifted surgeon, an artist with the DS, and a wonderful friend. Please - let me know if I can answer any questions, okay? Blessings, dina
   — Dina McBride

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