approval for RNY and DS...but I don't know?

on 4/12/11 2:06 am - OH
Post Date: 4/12/11 9:04 am
Well this is not to cause controversary, but  I have ins. approval for revision surgery from LAPband. My current surgeon *who placed my band* only performs RNY revisions, but I have seen sooo many post regarding the DS, it has peeked my interest.
I had my band placed in 2008, but have had slips and reflux and have just not lost the weight. I am currently 250 pounds, I am a sweet eater and try my best to not be or stick with sugar free options, but I don't think I could be happy with the thought of NEVER eating a piece of B-day cake again!! I also suffer from moderate arthritis and have struggled with the band and not being able to use adequate pain relievers! I am turning 40 this year, so I don't think the arthritis will get better as I age.
 I am from a small town in Ohio and have had trouble even finding a doc that does DS.... where do you look??
I am currently scheduled for RNY on 05/23/11, so I have some time to decide on what to do, but limited time. I have Med Mutual, Super Med and know they approve DS. Already talked to them. I guess since my surgeon only does RNY, I thought that might be the best route for me. But now I am re-thinking....
I have read a lot about "gas" and "diarrhea" issues with the DS....Also about laboratory issues and mal-nutrition issues.... Anyone who could offer some info on this, I would be greatly appreciative.
It seems the RNY and the DS ppl have very strong opinions with their specific surgeries and I am not out to cause a conflict, I just want to have the appropriate info to make my own personal decision. I know that if I choose DS, I would be giving up a very soon surgery date for RNY and I would have to locate a doc to even do the DS, which is going to require some extra work and headache for myself.... Is it worth it? Are the results that much different from a RNY for someone my age and weight? *i.e. 240 pounds and 40 yrs*.Thanks in advance!
Ms. Cal Culator
on 4/12/11 2:40 am, edited 4/12/11 2:40 am - Tuvalu

MOST of those issues will be within your control, but EITHER surgery, because they both rearrange your innards, CAN cause changes as to how you process your food intake.  Here are a few RnY stories: /#27418247 -the-right-place-to-ask-a-question/ / freak-i-smell/ ks-and-work/

I could get you many, many more links...but the truth is, rearrange your guts and stuff just works differently...REGARDLESS of the surgery.
on 4/12/11 2:46 am
If pain relievers are in your future (and yes, if we are realistic, then they are in MOST of our futures as we age) then you should think twice about the RNY. NSAIDs are contra-indicated for the RNY because of ulcer issues. Ask about that on the Main Board--you'll hear some pretty grim horror stories of people getting painful ulcers or are living in daily agony because they cannot take anything for their pain.

Yes, the results are different between RNY and the DS, far better long-term for the DS (read every page on But frankly, the quality of life is simply kick-ass for me and my DS. I am so normal in what I eat and can do that no one believes that I even had WLS and weighed 344 pounds. My RNY associates and friends struggle with their food choices. It's such a project to go anywhere with them because of their food issues.

I traveled to San Francisco from Chicago for my DS and I would do it monthly if I had to. Sure, the upfront things you may have to do to get your DS may be a pain, since you are on the RNY train, but it's worth it.

Feel free to read my blog here. Best of luck to you on your decision. It's been my experience that you get what you pay for in life. We all pay for the relatively "easy" route or "quick fix" later in life. Whenever I have to work for something, I spend more time critically thinking about it and appreciate my results more.


I had the kick-butt duodenal switch (DS)!

HW: 344 lbs      CW: 150 lbs

Type 2 diabetes and sleep apnea GONE!

on 4/12/11 7:18 am - AL
So you think you need malabsorption to lose the weight.  The question I would ask you is how important to you is KEEPING the weight off?  Can you keep the weight off through rigorous dieting and exercise?  Because that is how the RnYers keep their weight off.  Their malabsorption ENDS around year 2-3 so they have to diet and exercise to maintain their weight loss.  If you get the DS you also have to watch what you eat, but not to the degree that a RnYer does.  The DS is more forgiving.

The DS has the best scientific stats for not only losing the weight but KEEPING it off long term.  That, along with your need to take meds for arthritis are two strong arguments in favor of the DS.

The only argument in favor of the RnY that I can see is it is easier and faster to obtain.

You already had one failed WLS.  Do your homework, even if it means postponing your RnY and make SURE you are making a completely educated decision.


on 4/12/11 8:48 am - bay area, CA
The numbers don't lie. The DS has the best statistics of any wls for percentage excess weight loss, maintaining that weight loss (so important!) and resolution of almost all comorbidities. when I was on the RNY train way back when, I attended a local support group that was almost all RNY (with a few lap bands). It was a valuable experience. I met so many unhappy people who had done great initially but after 18 months or so were struggling to keep off the weight they had lost, nevermind lose more, and many were losing the struggle. and that's in addition to the side effects - the dumping, the food getting stuck, the list of foods you are never supposed to eat again, no drinking liquids with meals, can't take NSAIDs...but I think I would have withstood all that if it weren't for the high failure rate. Even my potential RNY surgeon quoted a failure rate of 30%. To me, that is not acceptable.
     The DS is so much easier to live with. You can take NSAIDs within reason. You can eat a smaller, normal meal. No dumping. No food getting stuck. And a very low failure rate.
     You are already looking at your second wls. The band, sadly, has the highest rate of reoperation of any wls, and while there are some successes, the failure rate is very high. So you aren't alone, but you really need to think carefully about your next move. Finding a DS surgeon is pretty easy, esp with this forum and to help you. Living with an operation that isn't right for you is very hard.

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