Mind is turning with Pre-Op choices.....

I have been spending the last few days doing much more research on the DS.  It seems as though now I am leaning toward it more than the RNY.  I just feel like I am swimming through all of the information on both surgeries, and I am weighing the pros and cons of both.  Then I sit down and write out what the pros are for each for me, and then do the same for the cons.  I have a lot of weight to lose and my biggest fear is getting the surgery and then to gain it all back again...that is what I have always done and then added a few more pounds.  I think that it is a reasonable fear for me.  The statistics for someone with as much weight to lose as me shows a higher success rate of keeping the weight off and losing all of the exess weight, which will be 260 pounds.  What do others think?  I have checked out the DS board and received their opinions, but wanted to know peoples opions here and why they chose the RNY over DS.

I won't be much help because I went with rny because that's what my insurance covered.  I do know that the research shows that RNY "cures" diabetes while DS doesn't have the same great results.  So if diabetes is a co-morbidity of yours then RNY would have to rate higher on your list just because of the damage that diabetes does to your body. Good luck on your research!

Actually Kathy, I believe the reverse is the current claim - ds cures diabetes, while rny puts it into remission.  Being someone *****ads a LOT of peer-reviewed journal articles daily, I am very skeptical of alot of these claims.  Being someone *****gularly writes peer-reviewed journal articles, and has performed peer-review for journals, I also know a lot of crap gets into the literature and can't be removed.  So take any of that info with a grain of salt, IMO. 

Hi scrapper, I had my reasons for RNY.  I was actually leaning toward DS for a while, even though I'd have to travel and would have to wait longer and go through some insurance hoops.  I decided, for me, that the vitamin deficiencies were bad enough with RNY.  I didn't want the increased DS malabsorption, especially since I want to get pregnant once or twice in the future.  I started very large - a BMI of 83.  I will most likely never get even close to a normal size, I'll be thrilled with under 200.  Technically, for my height 110-120 is where I am "supposed" to be.  That is likely unreachable with DS or RNY at this point.  The rate of regain is supposedly higher with RNY, especially in super morbidly obese individuals like myself.  I guess that will be up to me.  I am skeptical to trust a lot of that research though.  Peer-review just isn't what it used to be.  Another big reason for me was that there is a larger patient group for RNY, so most complications and long-term problems have already been seen and dealt with in the past.  That is comforting to me, as is the fact that many physicians are quite familiar with the procedure.  That's not always the case with DS.  There are definitely pros to DS, and anyone, especially anyone very large, should consider it strongly.  I did consider it, and I opted for RNY.  Dumping is a pain, but I wanted it.  Getting something stuck or having a grouchy pouch is also a pain, but I am so thankful for my surgery.  I've had a tough go of it, with complications, but I'd do it over again in a heart beat.  I feel human again. 

I have not read anything that says that you are not able to hold a pregnancy after a DS though.  What do you know about that?  Just wondering.....I have one child and my husband and I are currently separated, but what if one day I am in another relationship or get back together with my husband and want another child...  I have not found any information that states that you should not carry a pregnancy with the DS it just states that it would be difficult to keep up with the vitamins needed.  HELP!?!

I don't think I ran into any specific info either, and I looked - I just made some assumptions with the amount of fat soluble vitamins I see people having to take after DS.  Having malabsorption from either surgery could complicate a pregnancy, so very thorough pre-natal care and frequent bloodwork would be needed, but I just personally feared that it would be harder with the DS, and since one of the major reasons I had surgery was to have kids, I wanted to choose the surgery that had less chance of vitamin issues.  Not that RNY doesn't, believe me.  I take a lot of pills each day. 

Hi again Dunny, I posted on the DS board to see what some of them have to say.  Of course I think pregnancy would be something you would do with caution with either surgery.  More so with the DS due to the amount of vitamins that you do need to take to enure that your numbers are good.  You are right your doctors would really have to be on board with blood work etc. Jennifer

The thing about any malabsorbtive surgery is ANY PREGNANCY is going to leech everything it needs off of you so that is why you have to follow a hardcore vitamin regimen. That's not to say one surgery is better then the other BUT as my logic goes (and it's only my opinion) I would rather have a pregnancy with less risk of major nutritional deficincies then not because I wanted babies. But that is why I also chose the RNY because it was less malabsobtive. I'm still not quite comfortable some days with the choice of RNY because of the malabsorbtion so I know for a fact I would have major buyers remorse with the DS - better numbers or not. THAT is why one WLS isn't best suited for all - heavyweight or not. You have to research research and research some more and get what you want the first time. I just went to a conference this weekend that talked about revisions, etc. The thing about revisions, and why they are INCREDIBLY risky, is because when you go back in to change things up you're NOT dealing with a blank slate. You have scar tissue that has a hard time holding sitiches (which can cause leaks and kill you). You have things that can't be taken down to normal (if you're a revision from a RNY to DS) just from wear and tear. It's important to get what you want the first time!!!!! Now one thing you have to consider with ANY surgery is what if you're one of the people who don't end up getting to "normal". GUESS WHAT - a lot of the time it's not easy getting to "normal" when you start heavier anyway. It's like someone starting at 500 pounds wanting to get to 120 pounds - WLS isn't gonna get you there alone. No way - no how. There are too many factors that go into it. I know for a fact I won't ever be considered trim or lean. Hell I have no desire to be. But I knew going into RNY that if I got 70% of my excess weight of***** out of my SMO death zone I was in quickly and kept me out of it, and if *I* do the work required to be compliant then there is no reason I won't be successful for the long haul - statistics be damned. So choose what you want, read statistics if you want, but when you go into any WLS you have got to be willing to put forth the same amount of effort every single day for the rest of your life. No taking one week of here or there. So pick your poison and pick it right the first time.  Best of luck to you, Jenny

Hi, I choose the DS over the RNY because of the results Ds tends to lead to greater weight loss and less regain. Others things that were ds pros for me were that DS let's you have a more normalized life afterwards in terms of eating most foods (no dumping) and in amount. I know DS is more malabsobtitive then the rny but it can easily be controled by taking multivitimins, and supplements and by ensuring you are eating meat and diary products everyday. To me (and i could be wrong) it seems like with the RNY you end up dieting for the rest of your life where as with DS you get to live more normally. I am tired of dieting and want to live my life as close to "normal" as possible. If i am doing surgery i want to do it once and get the best results for me, i don't want to be a revision.  (i would suggest talking with the people on the revision board they might have some good imput. In regards to pregancy I don't have kids and desperately want to have two. I have done lots of research and have found no indication that i can not have Kids after having a DS. i talked to me surgeon about it and he has had patients who have had kids after DS with no issue. Either way the important part is that you continue on the train we are all on to managing our weight, good luck  catnip