DS and BPD ???????

what are the differences.. I know that they are usually done together.. but can someone tell me about the BPD.. the Doctor that I have been refered to only will do the BPD and not the switch part......so if I am going to have anything I need to know if the BPD is even remotely like the DS I am sooooooooo confused

I did not think anyone did the BDP alone anymore--there were lots of problems with that method including lots of malabsorptive problems, protein malnutrition, etc. As to how the surgeries are different, for one thing I know that with the DS the valve between your stomach and your small intestine is preserved--which means we have a normal filling and emptying of the stomcah--decreasing hunger, and, most importantly --eliminating dumping. Please do more research and think about it carefully before having a BDP w/o the DS Carolyn 317 pre-op/ 212 current

Warning -- the following is ONLY MY OPINION -- I am not a doctor, nor have I ever met anyone who had the BPD only -- I am just someone who has read extensively about WLS and DS related WLS in particular. Having said that, I would be running in the other direction from Dr. Patterson. I have heard a number of not-good things about her on the OH and Yahoo message boards. The BPD is a large pouch RNY, defunctionalizes the pyloric valve, creates an artificial stoma -- and the DS part of the surgery is what I understand provides the long term weight loss, avoids the dumping and provides the long term diabetes cure. I could be wrong about some of that, but one of the DS surgeons (I think it is Baltasar) is doing the DS on non-MO patients to sure diabetes. Here are some threads on the www.duodenalswitch.com message board dealing with Dr. Patterson and the BPD without the DS (you will need to join the DS site to read them, I believe): http://www.duodenalswitch.com/openbb/read.php?TID=1212 http://www.duodenalswitch.com/openbb/read.php?TID=44 I would be VERY cautious about having this surgery -- in fact, frankly, I wouldn't even consider it myself. I have heard some speculate that Patterson isn't comfortable doing the difficult DS part of the surgery (may have had some bad patient outcomes?) and decided not to do it anymore. I would encourage you strongly to look for another surgeon. Diana

I am seriously thinking about the RNY..

I would seriously consider the RNY as well, and did. I very quickly came to the conclusion that I would rather remain morbidly obese than have an RNY. I was approved immediately by Aetna for the RNY and fought Aetna for over 5 months to get them to approve the DS for me. In my mind, there is no doubt that the DS is a better surgery for me; no barfing; no dumping;, no marginal or pouch ulcers; little chance of weight regain; no blind pouch inaccessible to endoscopy; no strictures; can take NSAIDs; can eat anything in reasonable quantities; etc. I have had NO problem with getting adequate nutrition, my labs are perfect -- for the first time in years. My poops smell a bit worse than they did when I was pre-op, but I only have to poop at home, on average twice a day. I am almost 10 months out and up until two months ago was a VP in a biotech company, having to speak in public and travel, and I have had to go poop in a public place maybe twice, ever. I also get stinky gas if I eat bread or pasta or a significant amount of onions, so when I have to be in public a few hours after having the thought of eating such things, I don't. That's it. I don't take anything like Devrom or Innermint to control the smell of my poop or farts, because I don't find them to be a problem -- but I know that if I DID find them a problem, I could take those things. If you have the opportunity to get the DS, I cannot imagine why you would pick the RNY instead. Just my admittedly biased opinion, based on how comfortable I feel and how grateful that I did have it. Diana

there are no surgeons that take my insurance that do the DS.. it was always my first choice. I live on a small income so traveling to find one is no a viable option.. so I guess I am stuck with the choices available.. I know for a fact my insurance will pay for a RNY. I had a doctor up until Wednesday that would do the RNY.. I have also talked with quite a few patients with Dr Patterson. and they like her for their Banding.. and RNY so if that is what I have to do.. Trust me I have called around since Wed trying to find someone who took my insurance.. and believe me I am bummed about it

Before you give up entirely on the DS, make sure you understand completely what is meant by "a doctor who takes my insurance." What that means is, the surgeon has contractually agreed with your insurance company to ACCEPT the pittance that the insurance company decides to pay as payment in full (except for your copay). What REALLY matters in the big scheme of things is whether the HOSPITAL is contracted with your insurance company, because that part of the cost of the surgery is MUCH more and MUCH MORE VARIABLE, depending on whether you have even the most minor complication. If you really want the DS, and there is a DS surgeon around who "does not accept your insurance" and that surgeon operates at a hospital that DOES accept your insurance, AND your insurance company will cover the DS (even if it means a fight), the WORST that could happen is that you will have to pay all or part of the surgeon's fee, which is a fixed amount and usually between $6000 -12,000. A lot of money to be sure, but no more than the cost of a decent used car. You can often finance the fees. If you have a PPO, and there is no DS surgeon within some fixed distance (for Aetna, it was 50 miles), they are supposed to pay in-network rates for the surgeon; possibly, they have to pay in-network rates no matter what if there is no in-network DS surgeon. If you have an HMO and there are no in-network doctors who DO the DS, they should cover an out-of-network surgeon completely, and similarly they should pay for an in-network surgeon plus travel expenses if there is no surgeon within 50 miles. All I'm saying is, if you can get the DS covered, just because the surgeon you want to use isn't in-network, it doesn't mean your insurance won't pay ANYTHING, just that you may have more out-of-pocket expenses to pay the surgeon, i.e., the difference between what your insurance pays an in-network surgeon and what your out-of-network surgeon actually charges. That isn't $0, but it shouldn't be his full fee. You will have to live with the after-effects of this surgery for the rest of your life -- you might want to give some deep thought to accepting paying for a FIXED part of the costs, just so long as the hospital charges are covered. Good luck, whatever you decide. Diana

the Doctor that does the DS will only do the surgery at the hospital that does NOT take my insurance as of last wednesday... this creates a problem.. I can't finance.. I have terrible credit since my divorce.. I cant save.. cause I live on about $500 to pay my rent and everything.. if my insurance does not pay for it.. I cannot have it done.. I am stuck between a rock and a hard place.. and it is not nice.

Renee, if I were in your shoes I would have the RNY. The DS is better for most of us but since you cannot afford anything other than what insurance will cover go with the RNY with the reputable surgeon. That is my opinion. Good luck with whatever you decide. Carolyn Moore DS 11/03/03 317/212

Hi annette That is so great! I know how you feel just like everyone on the site knows. Isn't it nice to have people know how you feel about the little things. All the wow moments to us a normal size person would go huh? Good job. Betty