for new people researching weight loss surgery

I thought this site was for support not competition. I am just glad to be given a second chance at life no matter what surgey ive had. I truly believe we are all in this journey and struggle together and should be supportive of one another not worrying about comparing apples to bananas. Thanks and I hope everyone with evry type of WLS a happy and healthy new year.

Since these things get posted ad-nauseum, I put my general responses in my profile for the pre-ops who are curious about my experience with la vida loca RnY. As to a few specifics mentioned: 1.  Endoscopes most certainly CAN and ARE done - the only difference is that it's preferred they are not done BLINDLY after surgery.  This is one of the reasons getting a med-alert bracelet is a smart idea.  The tech/professional performing it needs to have a heads-up that the anatomy is different so they can guide it with the aid of camera - NOT because it's a no-no. If you're incapacitated and they suspect a gastro issue - it's important info. How does Hayley-Hayley suppose strictures get dilated in post-ops?  Endoscopic dilation - an endoscope with a balloon in the end of it.  Routine. 2.  Chewing food to a liquid is not only NOT what post-ops are told to do - I've even seen DSers counseling new DS pre-ops to chew their burger patties to a liquid - so if we're going to generalize - let's at least admit this is common to ANYONE who's had their stomach altered in some way in the initial first days/weeks after surgery.  Once an RnYer has gotten to a certain healing point - they can chew and swallow regular bites just as they did as pre-ops.  The point is not to "inhale" food - a caveat for anyone regardless of surgery status. 3.  NSaids - there was an informative series of posts about this here on the main board.  Nsaids aren't off limits to post-ops.  RnYers and DSers have an equal shot at developing problems with NSaids - the same shot non-ops have.  The point with NSaids is that they not be ANYONE'S first choice if there are alternatives. And people for whom NSaids are the only thing that works usually get the ok to do so, provided they buffer the dose with something to eat - as would anyone else.  Where NSaids can pose a problem is in people who are ALREADY pre-disposed to ulcers - in which case if they find down the road they need Nsaids on a chronic, long-term basis - they can discuss risks-benefits with their doctor.  There aren't many conditions out there for which there aren't alternatives to NSaids for relief, for some it can be an issue.  It's up to the individual to sort through their own health concerns and determine if this is a concern for them. 4.  Fat absorption and the taco meal.  There is NO reliable way to know how many grams people are absorbing or not absorbing of ANY nutrient - so to nail it down to specific grams is a bit misleading.  All anyone can do is estimate.  RnYers do malabsorb fat - particularly those with medial and distal RnYers - and anecdotally, myself, I know from experience that certain kinds of fats go straight on through. Not as extremely as a DS, but it does happen.  Malabsorption changes over time - for proximal RnY its a shorter window - for DS its longer - but no matter what procedure - you have to be prepared to adjust your intake when the time comes that the intestines begin to retrain themselves.  That day comes for everyone. The other important factoid about DS that isn't mentioned in that list is that while DSers malabsorb fat - they don't malabsorb the lion's share of white/sugar/carbs.  So people for whom carbs are a serious issue as a pre-op - it might slow down your progress post-DS.  But that's something to discuss with the folks of the DS board if that interests you.

1. Endoscopes - we r referring to different sections of the stomach. RYGBP construction makes the large bypassed distal stomach inaccessible to standard non-invasive diagnostic modalities. Neither x-ray contrast studies nor endoscopy can assess this potentially important but hidden area. 2. Chewing food to a liquid consistency/pureed food early post op is recommended for newly post op patients.

3. NSAIDs - smaller the tummy the more damage can occur.  Section of the stomach that is bypassed...i refer to as blind...can develop ulcers and endscopes are not used to view this hidden area.

4. taco meat was just an example - agree it is not an exact science. I will consider adding a disclaimer to that part. 5. I stated we malabsorb fat...unless someone confuses this for a carb they should assume we absorb carbs normally.  I could put eating low carb can help with losing weight but then some people get to goal without eating low carb. I'll consider putting something in the myth/fact section.

Thanks for the input. Have a nice day. 

A quick Google search brought this article up, which has pictures of different surgeries and is actually quite interesting to read if you're so inclined regarding endoscopy of the "blind stomach" or "remnant stomach":  http://www.gomedica.org/Download/Article_Endoscopy%20after%2 0bariatric%20surgery.pdf This is a portion of it that may not be commonly known: 

Familiarity with the expected endoscopic appearance in patients status-post bariatric surgery is of utmost importance. Knowing precisely which operation was performed is critical in order to ensure a safe and useful procedure. Therefore, whenever possible, endoscopists should discuss the bariatric operation with the patient’s surgeon prior to performing the endoscopy.

• If available, review all postoperative abdominal imaging studies, especially barium upper GI series. • Examination of the esophagus, gastric pouch, and Roux limb can be easily accomplished with a standard diagnostic upper endoscope. Depending on the indication for the procedure, a pediatric colonoscope or enteroscope may be used to examine the bypassed stomach, although this is not routinely done.

Visualizing the bypassed stomach is what is being referred to with the no endoscope statement I believe.  I was told viewing the remnant stomach was virtually impossible via traditional endoscope.  I assume they'd have to make an incision and go in that way instead, or go down the intestines and turn around at the y-limb.  Or maybe just go rectally.  I really don't know, but the statement is NOT inaccurate.  It could be refined a little to say "blind stomach or remnant stomach or bypassed stomach"  I was only put on acid reducers (zegerid, like prilosec) for 4 months, but I've never had issues with acid indigestion or anything.  That varies by surgeon - someone say its for the rest of their lives, others only do it for a month or two, and some for 6 months to 2 years.  I don't think the person who posted this was attacking RNY at all.  It would be nice to see the same info for lap band though, in fairness to all. 

Thank you, dunnybocter and yes that is what i am talking about.  I will restate it if it helps them understand what i am referring to by blind stomach.

And i will get around to making a lapband and VGS chart.  Then perhaps it wont look like an attack.   ok now it is really past my bed time. Night.

As a newbie on this board, currently in the pre approval process for bariatric surgery, I can tell you I have attended two separate Dr. seminars on RNY. Both Dr's who are very highly regarded in the RNY community, as well as on this website stated unequivicably that you CANNOT get a scope into the original stomach to view a possible ulcer or stomach cancer after RNY. Period. If your Dr. suspects an ulcer, you will be on medication for the rest of your life. I verified this twice as I have a family history of stomach cancer. I am still very much considering RNY, but this is something that has made me think a little harder and look a little closer at my other options.

Inability to easily scope the blind stomach was a big turn-off for me.  It's especially important if your family has a history of stomach cancer or if you have a history of ulcers. Like you, I consulted with a top RNY surgeon and he was familiar with the DS, but was so busy in his practice that he didn't have time to learn it.  If you want more info, you can check out www.duodenalswitch.com  or come to the DS Forum... also make sure you talk to a surgeon who actually does the DS.  DS surgeons are a more rare breed. 

Besides all the other reasons (including quality of life) that I felt the DS was the only surgery for me, I too have a family history of stomach cancer -- BOTH of my mother's parents died from it.  There is no way in hell I would have had a procedure that resulted in 9/10ths of my stoma*****arcerated in a blind pouch which could not be scoped.  It helped me get insurance coverage back in 2003 when Aetna was not usually covering the DS. 2.5 years ago (I am now almost 4.5 years out), I started having trouble with vomiting.  I was able to have an endoscopic examination of my entire stomach, proximal duodenum and jejunal anastomosis with no problem.  This would NOT have been possible if I had an RNY.  (Lucky for me, it was stress-induced gastritis, fixed by changing the acid reducer I had been taking for over 5 years which was no longer effective for me.)

Hayley-Hayley! Thanks for posting this! I hope that this post reaches some person that is struggling to find out about WLS. Some people come to this main board and never get exposed to surgery types other than the RnY or Lap Band. You have taken a beating for this post but I know the spirit in which it was intended.  The myths I heard about the DS from surgeons wanting to sell the RnY frightened me away from WLS for over a year. But, I kept researching. The DS myths scary to me but I kept researching. I wanted to lead a normal life and eat sweets if I wanted them. I wanted to celebrate my grand kids birthdays with cake and margarittas....oops...another story. Maybe just the margarittas.... I looked at the after life of both surgeries and the complication rates. I made the choice for ME. I am glad I chose the DS. I just wish everyone would do their homework and make informed decisions. I am very happy for those that are happy with their surgeries...no matter what type. I am sorry for those that did not have a choice. Thanks for giving a voice to the DS today. HAPPY NEW YEAR! Dianne from FL