Help deciding which surgery to have
on 6/17/11 11:17 pm - Califreakinfornia , CA

on 6/16/11 5:38 pm
I wanted to only have ONE surgery, with the least chance for a need for a second (or third) revision surgery, so I researched the heck out of it. There is lots of great info as well as links to medical studies at DSfacts.com
Don't get a band. Just don't.
Look at the VSG and the DS as the best possible options.
I was originally on track to have RNY back in 2002, but got derailed after preop testing revealed that I had pulmonary hypertension. It's a long story, but it's on my profile if you'd like to read about it.
Even though I was off the track for RNY, I continued to attend the program my then-surgeon required of all his patients. I'd paid for it, so I figured I could benefit from it anyhow :-).
I saw some disturbing trends there. This was a big group, as several surgeons sent patients to it. There was, of course, a cadre of very successful patients (all RNY). They finished their year of program and went on with their lives, and as far as anyone knew/knows, all is well.
There were a surprising number of people, though, who fought and fought and fought to comply with what was expected of them, and the weight didn't come off well. At every meeting, there was word of someone else in the hospital with this or that problem--usually an ulcer or a stricture.
I listened to stories of dumping episodes, of getting food stuck episodes, of the mental/emotional challenges of having to live on highly restricted diets.....and I thought, "There's not a chance in hell I could live with this." (I should add that I have a major vomiting phobia. I'll do just about anything to not vomit. Not a good thing in some cases.)
Well, time passed, I got fatter and sicker, and eventually (again, story in my profile), it came out that the pulmonary hypertension was caused by the fat on my torso squashing my heart and lungs. It went from, "You cannot have any surgery at all," to, "You must have surgery or die."
I came back here to OH, feeling desperate because the lap band wouldn't give me enough weight loss to have any real hope of curing what was ailing me, and the RNY seemed to me like foolish butchery for not enough good results.
Someone told me then about the duodenal switch, invited me over to the DS board, which at the time was pretty much brand new, and the rest was history.
What I like about the DS:
1. 98% cure rate for type II diabetes. This was a major biggie because I had very bad diabetes.
2. Normal stomach anatomy and function is maintained. The stomach is reduced in size, but the normal stomach outlet, the pyloric valve, remains intact and functioning. There is no "stoma" with the DS or the vertical sleeve gastrectomy (VSG).
3. The intestinal changes that are done in the DS "jump start" the body's metabolism. Mine was shot to hell from a lifetime of PCOS, dieting and other factors.
4. I'd already done many years of low fat, low carb, highly restrictive dieting and I knew I sucked at it. The DS gives an eating quality of life that I find easy to live with: eat a primarily animal protein based diet. I'm a happy carnivore :-). I had to learn to restrict my carb intake, but it was a lot easier to do when I could eat meat, cheese, fish, eggs, etc. with abandon, with little regard for fat content. (DS'ers only absorb about 20% of the fat they eat, so for most of us, fat is almost a "free" food.)
I felt so strongly about the superiority of the DS to any other procedure that I traveled and paid out of pocket to have it done, rather than have the RNY done fifteen minutes from home and covered by insurance. It's been over four years, and so far, so good :-).
Please come over to the DS board and visit with us there. Lots of folks will be happy to tell you about their experiences.
Having said that, I'll say this. I am a RNY revision surgery from lap band. I had my band placed in 2008 and had complications and 2 slips so I just underwent RNY revision surgery on the 23rd. Best decision I have ever made and I am so thankful to have the band out!
I had initially wanted VSG, but after talking with my surgeon, who placed my band back in 08 so I know and trust her and have an awsome relationship with her, she felt that RNY would work better for me with my personal situation. So I took her advice. You have to have a trust relationship with your surgeon so pick one accordingly. Make sure you feel comfortable with the surgeon you choose, that they are experienced and that they perform most if not all of the WLS available, (mine does not do DS, only a few docs do in my State and I would have to travel quite a distance and my ins. does not cover DS, not to mention I am at 41 BMI), but that gives the surgeon better experience to know how to advise you with the different WLS. Everyone's eating habits and health issues are different and you have to choose accordingly.
I wish you the best of luck and I know it is a difficult process, but well worth it in the end!
Just educate yourself as much as possible! You are WORTH IT!
on 6/17/11 12:00 am
I personally thought dumping syndrome sounded hellish, and I wanted to avoid even the possibility. The best way to avoid dumping is to keep a functioning pylorus. (But dumping CAN happen to anyone, even 'normal' people.)
It's the very unpredictability of dumping that made it a deal-breaker for me.
HW - 225 SW - 191 GW - 132 CW - 122
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on 6/20/11 9:13 pm