RNY, DS, and LAP BAND WARS....................

I wasn't insulted, just trying to inject a little humor into this topic.  I think it is sad that people think of this as a war, and act out as such.  Insults never win a debate. 

As to the California Board, I feel quite at home here.  I am only living in Cali until March, but am already looking to extend my contract in LA cause I enjoy it so much.  If I can't get LA, I may head a bit north and check out SF. (I love being a traveling nurse).

Hmmm, My mom had Lap Band. Does that mean I am suppose to down her for her choice and tell her it was wrong and not support her? Hell no she has done great and admits it is because of the support from me and info I pass on to her from this board. She has met people from the board, RNY and LapBand, both come to the lunches and GUESS WHAT....WE ALL GET ALONG AND SUPPORT EACH OTHER. That is the purpose of this board right???
Well said and kudos Janel!!

Not singling you, or anyone else here out per se, but ASSUMPTIONS that we all arrive at our chosen WLS making fully informed decisions is astoundingly NAÏVE. Almost as staggeringly IGNORANT is the suggestion that Bariatric surgeons have nothing but our best interests involved and that we should just take whatever they say as the unquestioned gospel.  In fact, what is presented on this board as well meaning helpful support is often categorically WRONG and even disingenuous. And I could say the same for nearly every OH board category here. While I tend to try and lean toward civil tact in my approach, blowing happy rainbows up one’s arse is not particularly useful or helpful in aiding someone clearly off track or who is being misinformed by a physician or by his or her staff. God knows I spend an inordinate amount of my personal unpaid time directing post-ops in trouble to the right physicians and making nonlicensed medical suggestions subject to their treating’s OK to correct the rather serious medical sequella these sad folks find themselves in. Frankly, I’m AMAZED at the ignorance I see on a nearly daily basis on OH, and frankly, what the medical community at large dictates regardless of the specialty disciplines represents when it comes to WLS post and pre-ops. Truly SAD!

Take off your ROSE COLORED GLASSES and EXAMINE what just happened here and with the related titled post. Diana, has as she has occasioned in the past here and elsewhere, made an innocuous, informative post and would have gladly left it at that, and has done so in the past. It’s an appropriate time as we all can likely remember making New Year’s resolutions to lose weight. Yet, with this single innocuous post which she clearly directs to pre-ops and those seeking revisions generates not gratitude or support for her efforts to be fully informed, but wielded barbs from many of you.... Janine’s post- perhaps being the exception as more reasoned, but I think she even errs here. She cites, as do others I’ve heard from here- some nondescript person who failed at having the DS. Fine.... certainly possible and I have read some medical accounts, but I have yet to meet one. But I also recall Janine herself bemoaning some significant regain when I last had the pleasure of seeing her at an OH convention. An OH convention which was hardly atypical where MOST of the long term post-ops were clearly still OBESE and where I was nearly the only DS'r represented there.

I have heard from DS’rs who have specific nutritional sequelae they have been concerned with but not a single one seeking a revision. Contrast this with hundreds of tearful PMs and nearly as many public posts from other WLS post-ops with MAJOR regret, serious lack of weight loss, serious regain and/or equally serious correlated sequelae.

Frankly, these posts from many of you make me ASHAMED at being a resident in CA and even more so at the posts I see displayed here as member of OH. I was in Alaska in November were people seem more real and I just got back from Michigan where I buried my rather young mom on my birthday.  I still took time there to respond privately to PMs from distressed post-ops. NO, I ain’t no saintly enterprise. I just try and pay if forward when or where I can which, frankly has been too sparse lately.

Unlike what seems the consensus HERE. The DS is NOT a license to eat so called junk with abandon. It’s really about eating like a normally thin person eats whi*****ludes some of what is traditionally taboo for dieters.  It would seem not having to spend the rest of your lives with yet another strict dieting proticol isn’t such a bad thing if one remains healthy and has the envious labs and sustained weight loss to prove it. - Again, the way normally thin people eat. Are they to be CONDEMNED, TOO!!!????  Diets are generally foreign to naturally thin people and certainly have never worked in the long-term for any of us!  Have they? Why is a surgical solution for the rest of us morbidly or supermorbidly obese wanting similar lifestyles to that of the naturally thin person so soundly rejected here?

I apologize, but many of your posts are so profoundly callow. I didn’t stop researching after deciding on and having the DS. I’ve done thousands of hours of research since because of my medical background and interest thereof. Am I an authority? Hardly!!!! But I would gladly argue quite convincingly in court given any standing that neither are the many so called general Bariatric surgeons advising their patients pre and post-op about what is best for them. Trust me, I have the patient's records in hand that are nothing short of medical malpractice!! Chalk it up to my nature and my love of science and medicine in particular, but I love being helpful when and where I can. And taking on the medical community and managed care where it needs to be made accountable is something more knowledged capable people need to do. 

Make no mistake! I'm delighted with the success stories here having had other WLS surgical interventions. I know for a fact at how much harder you have to work in general maintaining what is essentially so effortless for yours truly who rarely has to think more than how much protein I have taken in for the day. Most of you success stories have to diet for life and are to be applauded for being able do so after what so often failed you dieting preoperatively. But I would argue you folks are hardly in the majority long-term.

For those of you not intimated by the ignorance and defensiveness presented here, do feel to PM me or Diana if you’re so inclined.

Rock

Rockne, that was an excellent post, very well-written and tactfully expreseed...bravo!

Amazing post Rock!  Diana is simply sharing knowledge...and for people to act like she is stealing their first born..well it's simply ridiculous.
  Shortly after she posted about fighting Kaiser someone posted on the DS from Ca asking on how and if she can fight Kaiser for a DS!! So YES Diana's post was certainly warranted.
     Great for those *****searched and made the right choice for them. Not everyone researches or knows where to go. We see this daily on the Main Board. So knowing that, why would the members of the Ca forum begrudge someone posting information on how to fight insurance and about another surgery they may have not heard of?
  I think sometimes the members of the Ca forum think this is an extension of the RNY forums and get pissy when someone posts about another surgery..like its an affront to their sensibilities.


Knowledge is Power!

Thank you, Maya. It's good to see you here.

Rock

Wow - I have ignored most of the 'my surgery is better than your surgery" posts because the negativity and divisiveness is bothersome.  I was about to do the same until I read Rock's response.

While I did a lot of research (certainly not thousands of hours) on the WLS types, the reality was that I felt that the pros and cons of RNY was best for me.  It was important to me to gain more balance in the types of food that I ate as well as how much. When I started the process and found out after meeting with my PCP that my insurance only covered RNY and LapBand.  Now, don't think for a second that if my chosen surgery type wasn't covered I would have changed my mind - because I surely wouldn't have.

So now I am about 13 months out, have lost about 115lbs, am stronger, mobile and excited to lose 33lbs by 18 months.  While I am (as Rock referred to) technically still obese - I am well on my way to goal and VERY happy with my choice of surgery.

From the 'war' posts, it is obvious that many DS patients feel very much the same about their choices.  So let's see if we can discuss that without spite or ugliness.

Both surgeries consist of a restrictive component and a malabsortive component, so why does there seem to be such a great divide in people's feelings about them?  Yes, the malabsorptive aspect results in more fat not being absorbed in DS - but are the surgeries THAT much different in their actions/results?  Meaning - aren't they both very good choices for large percentage of excess weight lost/maintained?

Both DS and RNY patients have to be compliant with their nutrient and eating ha*****anges if they want health and weight loss/maintenance, true?

I want to say thanks, in advance, for any folks who have had DS who are willing to address my points/questions above with respect and good information.

Cathy C.

"While I did a lot of research (certainly not thousands of hours) on the WLS types, the reality was that I felt that the pros and cons of RNY was best for me."

THAT is excellent.  Personally, I do not care which direction you choose as long as you made an INFORMED choice.   Only you know what is best for you, but you can't make that decision properly if you don't know what your options are.    THAT is one source of the passion behind many DS'ers who post in the wilds (ie - places other than the DS board). 


"but are the surgeries THAT much different in their actions/results?  Meaning - aren't they both very good choices for large percentage of excess weight lost/maintained?"

Two very different questions:

1)   Are the surgeries that much different in their actions/results?  

Yes.   Statistically, the long-term results RNY and DS are significantly different.    The ten year results from Dr Hess showed that 80% of his patients maintained 80% EWL after ten years.     The results for the RNY (5 yr) show that the average patient loses 64-75% (depending on the study) of their EWL within the first two years, but a large number (over 30% but I don't have the exact number with me) have significantly regained.     You can find these studies by going to www.pubmed.com and researching the various surgeries there. 

The original EWL (80% vs 75%) isn't statistically significant, but the weight *maintenance* is.

Does this mean a RNY'er can't be successful?  Of course not.   There are many who are. 

Does this mean a RNY'er can't be MORE successful than a DS'er?  Again, no - it doesn't mean that.   Even Dr Hess (pioneer of the DS) had a failed DS in his study (someone who lost less than 10% EWL), so any RNY who lost more than 10 lbs did better than that guy. 

 It simply means that clinical data indicates that the AVERAGE DS'er will do better than the AVERAGE RNY'er in the long run.   

2)  Aren't they both very good choices for large percentage of EWL/maintained? 

Given the alternative of morbid obesity?   Absolutely.     Anything is better than "impending death by definition", which is what morbid obesity means.     I applaud *anyone* who finds a way out of MO, whether by surgery, dieting, or sheer luck.  



Note - I stumbled on this question by searching for a post written by a RNY'er cabin111 who posted on the DS board, so while I'm not a resident of CA (at this time - I used to live there), I hope that my responding to your question is welcome.

--BT

BT,

Thanks for a great answer, which confirmed what I have been learning.  Which is - both DS and RNY are effective tools as long as the individual lives up to their responsibility to use them to their best.  Not that the regain issue isn't significant, but it is something our actions can greatly affect/prevent.

Cathy C.