DS v. RNY and PA doctors?

Hi All,

I am currently in the process of getting RNy with Temple University Hospital in Philadelphia. My chart is heading for insurance review with a tenative surgery date of 2/26/13.

I keep wondering if I should reconsider and have the DS but I'm afraid to stop the wheels in motion for me to have my surgery. I am a dental hygienist and have all cleared my schedule i March for this. it would be a big hassle to stop this process now...

BUT my biggest reason for WLS is resolution of diabetes, sleep apnea and high cholesterol. My BMI is 40.5.

Some reading I've done suggests maintenance becomes hard at the 2nd year and weight gain probable. I'm wondering how you can gin weight after WLS if you don't have a stomach big enough to eat alot?

What is the biggest lifestyle differences between DS and RNY? Success? Supplements?

I've asked my doctor, but he tells me that DS is more for people with larger BMIs as a journey to RNY if I understood him, but I am wondering if he does many DS surgeries.

I've also read the term "vetted DS doctor". What does that mean and are there any recommended DS doctors in SouthEast PA?

Thanks, appreciate any feedback.,

Deb

Your BMI does sound low for a DS surgery.  Have you considered the Vertical Sleeve Gastrectomy?   There are less potential consequences down the line (Ulcers, malabsorption, dumping), and over time it has the same weight loss as the RNY.  With the sleeve, the part of the stomach where the hunger hormone is produced is removed, so we don't get hungry.  I understand that is not the case with RNY and my friend who had an RNY wishes she had the sleeve.  Does  your surgeon does the sleeve surgery?  If not he may be a bit behind the as it is gaining more popularity and most insurance companies cover it now.  Check out the VSG forum here.   Good luck to you.

Thanks for your response.  He does do the sleeve, but I am looking to resolve my diabetes and sleep apnea.  This is my main motivation behind this surgery.

It seemed to my that the sleeve would allow the most cheating and therefore weight gain back.

What procedure did you have?

Anyone who qualifies for WLS qualifies for the DS. We have several posters on the DS board who had their DS with a BMI between 35 and 40.

As a DSer, I have a Sleeved stomach, and let me assure you, hunger DOES return. You're very early out, so you may well NOT be hungry---yet. Personally, I'm glad to have my hunger back. Eating without appetite SUCKS. (*grin*)

Your BMI does sound low for a DS surgery.

My surgery BMI was all of 35.2! I barely qualified for WLS at all but having qualified, my options AT the time cause I am a medicare patient was the lapband (NOT an option for me), the RNY AND the DS! The sleeve was not an option AT the time, that has changed.

There are several lightweight DS'ers here   quite a few. Many of us had a BMI between 35-40. My husband, who had the DS 5 weeks before I did was also a lightweight at a 38. So as long as the OP qualifies for WLS, she can handle a DS.

Liz

I'm trying to get a sense of the Vitamin supplement for maintenance with DS...may be a deal breaker for me.  Can you tell me what you all take?

If it's a deal breaker with the DS it will also be a deal breaker with ANY of them. Consider supplements like a needed medication...not optional.

However, what you take will depend on your individual labs. What I take at 2 years out will be totally different than a fresh post-op. I've had time to tweak mine.

Most start here and then adjust according to lab work:

http://www.gblcreations.com/Resources/Gina/VitaLadysLabsandT argets_11-2009.doc

http://www.gblcreations.com/Resources/Gina/ProgramDRNY_ERNY_ BPDDS3-2010.pdf

http://www.gblcreations.com/Resources/Gina/ProgramPRNY2-2010 .pdf

http://www.gblcreations.com/Resources/Gina/ProgramAGB&VSG2-2 010.pdf

Notice that the RNY (EXCEPT for the proximal) use the exact same starting point as the DS.

Liz

Here's what *I* take, based on what my current labs are telling me:

Breakfast: one multi, 1 dose (two tablets) calcium citrate, 1 50K D

Lunch: 1 dose calcium citrate

Dinner: Calcium, multi

Bedtime: iron

Some people take a lot more, including some RNYers. I'm 9 years post-DS, BTW.

You can get all your questions answered at dsfacts.com and check into the DS forum here for more answers.  The short answer is don't let your impatience to have WLS cause you to make a choice you may regret.  For resolution of diabetes and other comorbidities the DS is the best, as well as for keeping the weight off long term.  The post op eating is different and more forgiving then the RNY.  There is a lot of vitamins with the DS because the malabsorption is greater but vitamins will be a big part of your life after any WLS.

Can you elaborate on the differences in eating and vitamins?  There is one doctor near me that is on the dsfacts list.

It seemed like more bad side effects with DS...gas & diarrhea, acid reflux and more vitamin and supplement (but how much more)?

Thanks for any help you can give...