Lil' Scared of DS..... Please help!!!!

Yep, these complications are a possibility for many types of surgery.  We choose wls when these risks are ourweighed by the risks of remaining obese.  I'm 3 years + out, myself, and have had a very easy time of things, and been maintaining at goal for over 2 years now.

1. I would like to know who has had complications of the surgeries and what were they?
If you want to consider this a complication, I got a ventral hernia repair about 1.5 years post op, during an event where I thought I was invincible and lifted a 2 cu ft bag of topsoil on my own.

2. How long were you in the hospital?  Out of work?
I was in the hospital for 4 days, then I took 8 weeks off of work.  I was very thankful for the first 6 weeks and could have returned to work, but it was the winter holidays - why bother? 

3. What the heck is "dumping"?
Dumping occurrs with about half the RNY patients.  They eat too much fat or sweets and because they don't have a plyoric valve controlling how fast food goes from their pouch to their intestines, the food "dumps" in too fast to their intestine causing severe reactions.   This is not an issue with the DS.

4. What kind of scar do you get from DS, especialy Lap DS????????
My DS was open, and ugly, but if I ever get plastics, it will be gone.  I'm not concerned about it at all.  I knew that without plastics, there's no chance in heck I'd be baring my belly for any reason with the loose jiggly stomach I have.

Anyone not scared chitless about major surgery is an idiot.  And I mean that is the nicest way.  A lot can go wrong!  But a lot can go right and the surgery can be a big blessing.  Even at my short time out, I'm seeing differences,  Not that it's been light and breezy, yet it is getting better.  I've had a lot of nausea that makes it hard to eat or drink.  When I weighed my options, I decided to risk the surgery.  I have severe sleep apnea.  Yes, I use CPAP.  I have severe arthritis in my knee and it was only getting worse.  At the ripe "old" age of 57, I figured with my genetics and health, I had maybe another 20 years left.  I don't know if if my surgery is going to give me more, but I do know I will retire my CPAP and get a knee replacement when I get to goal that will make those 20 a lot more enjoyable.

Continue to do your research and best wishes in finding your path to health and well being.

I just got off the phone with my Insurance Company and it seems everything is covered, as long as it fits the guidelines of the doctor and medical management team.  She would not get into the exact terms as i was digging for them.  Anyway It has to be done at University of Pittsburgh as I have a UPMC HMO.  Im ok with that because they are one of the best hospitals in the country.

The doctor I have been researching is excellent and she performs Ds as well as LB, so I am getting an apointment with her to get the ball rolling.

You ex-fatties are awesome, thanks for the support and I wish you all a reat New Years. 

Oh great news!   Who is she that performs the DS in PGH?   Great to know.

Tom

Dr Anita Courcoulas adn her staff (Director Of Bariatrics...University Of Pitt. Medical Center)

http://www.obesityhelp.com/morbidobesity/bariatric+surgeon+profile+Anita+Courcoulas+fh.html

http://www.upmc.com/MediaRelations/Experts/pages/ExpertsPage .aspx?ExpertID=8

We have no DS patients of Dr. Courcoulas  here on OH.  She may have performed or assisted with a few and that's how she claims to do them here on OH. 

If you are limited to surgery at UPMC then you may be limited in what surgery you can get if you are not willing to self pay for the surgery of your choice.

We have seen this many times and speak from experience when we say beware of the "Bait and no Switch" docs that claim to do the DS and then say it's not really for you.  Your not heavy enough etc.  The truth of the matter is that they don't do it as a regular WLS procedure.    

What was another red flag was that they speak more of the BPD then the Duodenal Switch or BPD/DS.  The BPD is not really performed anymore in the US.  If they really do these procedures they would have current accurate information on the site.

http://www.upmc.com/Services/WeightManagementServices/OurPro grams/SurgicalWeightLoss/SugicalOptions/CombinationProcedure s/Pages/Duringtheprocedure.aspx

Biliopancreatic Diversion (BPD)

In this more complicated malabsorptive operation, two-thirds of the stomach are removed. The small pouch that remains will be connected directly to the final segment of the small intestine, completely bypassing the duodenum and the jejunum. Although this procedure successfully promotes weight loss, it is less frequently used than other types of surgery because of the high risk of nutritional deficiencies. A variation of BPD includes a “duodenal switch" (BPDDS), which leaves a larger portion of the stomach intact, including the pyloric valve that regulates the release of stomach contents into the small intestine. It also keeps a small part of the duodenum in the digestive pathway.

We wish you well and hope you can get the DS as you wish.  From hanging out here you should see most LOVE the DS and the after life it creates.  Check out the revision and regrets board for info on how many feel about thier RNY or lapband.  

I truely hope we are wrong here, but we are just trying to arm you for what you may be up against.  Please don't take offense.   Let us know how your first consult goes with the office.

Tom

Hi Tom.

Well i finally went to a presentation today at UPMC in Pittsburgh.  I was really impressed with  Doctor Anita Courcoulas as well as the information that was included.  Pittsburgh happens to be a Center of Excellence in the Bariatric field with over 20 grants from the government to continue exploring and improving new and current procedures.  They perform over 1100 surgeries a year with 6 dortors.  She also went on to include how UPMC rates of  any side effects or complications are well under the national average.  She also said she has never had a patient get a leak, as far as bypasses go.  She has only known of one LP slippage inher career.

The seminar was about 45 minutes long covering all the necessary issues you will experience from seminar, to 6 month diet, to getting insurance on board to the surgery and after care involved.  She had said that they were experts at the insurance business and has had no problems getting insurance to cover their patients.

I asked the question about Sleeves and DS?????  She said that she DID perform those surgeries, both DS and gasstric sleeves but was only covering LB and RXY in the presentation becuse the information seminar was not long enough to go in depth about all the details in the diffeent surgeries.  She was very nice and said she would discuss all options when we meet with her one on one.   She did say that many feel DS is a better surgery because they can eat more but they have more bowel movemnets and diahrrea.  Though she wasnt in no way disswading anybody from amy of the surgeries.  She basically saif d tha alot of your options will be based on your morbidity, health, and current anatomy.  Some people inth eseminar already had RXY or missing intestines or screens in their bodies so some of that information would factor in some decisions.

She was very clear that DS was much more complicated and carried more risk.  She really pulled no punches and was very matter of fact making sure she answered everyones last question.  She even stayed afterwards and had people come to her and answer any other questions they may of had.

But for all of you in Pittsburgh area, UPMC does do DS.  

I was very impressed with her as well as the whole program.  I have completed step one and next is the 6 months weigh ins as well as PSY and meeting with NUT.  I do however think im leaning towards the LB as they have hugh success in their program with that as well as all the surgeries.  It is just a personal decision and i feel good about it.

Good Luck to All.

She misinformed you, and I bet almost anything they will try to talk you OUT of the DS when you go for your consult. Here are her inaccurate statements:

She did say that many feel DS is a better surgery because they can eat more but they have more bowel movemnets and diahrrea. - Incorrect. Per a recent study released just last year, there is NOT a statistically significant diference in the number of daily bowel movements between RNY and DS patients. Also, ask around here--almost NO ONE has diarrhea.

She basically saif d tha alot of your options will be based on your morbidity, health, and current anatomy. - Sounds to me like she's going to try to say the DS is only for "extreme" cases. If you qualify for WLS at all, you qualify for the DS. Period.

She was very clear that DS was much more complicated and carried more risk. - Incorrect. In the hands of a GOOD DS surgeon, the risk rates between RNY and DS are about the same.

I still don't think they actually perform the DS. I think they SAY they do so you don't go elsewhere, and then convince you to have something else instead.

No they definitely perform the DS. 

Also those comparisons about complications and numerous bowel movements/diarrhea were between Banding and DS, not RXY and DS.  DS is definitely a more complex  surgery in that there is more cutting and connecting vs LB and you also poop much more than LB.  That is all i was getting at.  I was only interested in LB and DS, not RXY.  But if  as taking a much bolder step and getting gastric, then DS would be for me.  But i am confident LB is much more suited for me.  I don't mind slower weight loss to avoid the loose skin. 

I hate to tell you this, but loose skin is not going to be alleviated by slow loss.  It's mainly a genetic thing, like stretch marks, that determines your skin's ability to bounce back after major weight loss.  Please don't factor that urban myth into your decision making process.  You could lose 150 pounds slowly or quickly and still have the same amount of loose skin, that no amount of diet or exercise will shrink.

I hope that your surgeon really performs the DS.  Be prepared, though, to hear "I think you'd be better served by something else."  We hear of that all the time on this board, from people who went to surgeons who list the DS as one of their surgeries, but don't really do it.  They can say they do it all they want, but it's what happens in their consults that counts.

Good luck, and keep us informed!