Why RNY

Good Afternoon All,

I was just wondering if anyone would like to say why they chose RNY.  I am concerned with long term sucess and from what I've read DS is best for this.  Any comments?  Thanks!

I hate it when people answer a question with a question but that's what I'll do.

What is your goal? Is it to be skinny? Is it to have a normal relationship with food? Do you have co-morbidities?

There is no "one better" surgery (no matter what the more fervent DSers say), there is the surgery that is best for YOUR unique situation.

I chose RNY because I needed a radical break up with food. Food was like that horrible boyfriend that treats you bad but you can't seem to cut it off. I needed the possibility of dumping. I needed to get SICK if I didn't do the right thing. Granted, I didn't know about the DS going in, but for those reasons I'm pretty sure I would have still chosen the RNY.

I know others whose relationship with food is not like mine. They simply need to eat less. For them, Lap-Band has worked great. I've met others still who didn't want to have the potential limitations on food choices and chose the DS (btw, there are many, many worthy reasons to chose the DS, I am just citing the reasons of people I personally know).

So you have to examine YOUR issues, what made YOU obese, what challenges YOU have to overcome and then look at how each surgery would address those. That will lead you in the direction of the right decision for you.

Hope that helps.

What Nik said!

Really, as she pointed out, I only knew about lapband and RNY going into this.  By the time I knew I did not want a lapband, my course was pretty much set and I did not feel I wanted to change things.  My insurance through my hubby was ending soon and there would be no chance of having the surgery after that becuase my insurance (as a hosployee employee....go figure) excludes WLS.  

I did learn about DS prior to my surgery and I could have switched doctors if I really wanted to...but as Nik pointed out, I also needed a "breakup" of sorts with food.  I was a compulsive emotional eater and a carboholic.  I need that fear of dumping to keep me straight.  I also felt that as a person with less than 100lbs to lose,  the DS was too big of a surgery for me.  I feel that I am in control of my eating rather than it being the other way around and I like that...I feel better about me and not so out of control....if that makes any sense.

I have met plenty of long term sucessful RNY folks.  Having said that, there is some evidnce that the DS is best for long term sucess for the person with a very high BMI...I did not fit that profile....but for others may be a concern.

So far, at a year out, I am good with my choice....but my issues and my way to control them are unique and may not apply to you.   

 I had a nice, long post written and it went poof :(
To try to make it short.  I did have a DS in 2002.  I choose it because of the stats of keeping the weight off.  It hadn't met me yet.  I lost 120 lbs and regained 100.  I take full responsibility for the gain.  I did nothing to change my eating habits.  I bought into the "you can eat anything" mentality that was going around then.  First off, it is unlikely you will be able to tolerate all foods.  Most people have issues with something.  For me, eating refined carbs caused me to have deadly gas, bloating and terrible diarrhea.  At that time I didn't know that would happen.  All I knew was that I was eating what I wanted and losing weight.  I took the side effects as the price of admission.  I also became lactose intolerant.  I was willing to live with those things because I thought that was the way it was and at least I was losing weight.  Until I didn't.
To make a very long story short, by the time  I was 6 years out I was miserable.  I was gaining weight rapidly, had constant gas and diarrhea and was fatigued to the point of not being functional.  I regretted ever having weight loss surgery.  I went back to my surgeon and begged for a reversal.  I found out it couldn't be reversed, only revised so I didn't malabsorb so much.  My surgeon offered to give me a RNY pouch and I went for it because I was scared.  I had gained so much weight with malabsorption I was afraid of the damage I would do without it.
The surgeon and hospital I went to no longer perform the DS because of all the problems they have had.  To be honest I am sure the reason there were so many problems is because of the poor follow up and pre op education.  My surgeon has a reputation of not being very good at performing the DS.  In 2002 there were no real vetted DS surgeons.  It was fairly new and most of the surgeons doing it had only been doing it for a short time.
I never saw a nutritionist once.  I was given practically no post op diet and as far as vitamins I was told to take a multivitamin and some calcium citrate.  I read on the Internet that I needed ADEKs so I ordered those.  When I started regaining so much weight I made the mistaken assumption that I was again absorbing vitamins and I stopped taking the ADEKs and I didn't take as much calcium as I should of.  As a result I had very low vitamin D, osteoporosis and needed an iron infusion.
I did at one point cut out all refined carbs and that helped the intestinal issues a bit but I still had problems.  I had accidents that made it difficult to leave the house.  I never spent the night with my boyfriend because I was afraid of having an accident in bed.  The only time I had relief was when I took Flagyl but my doctor didn't want me on that too much because of the fear of developing resistance.  My surgeon told me that some people develop chronic bacterial overgrowth because of the shortening of the intestines.
My surgeon also left my stomach too big and I was always hungry and could eat as much as I could pre op.
Anyway, I had my revision a year ago next month.  I used the surgery as an opportunity to detox from refined carbs and I haven't had any since.  I have not experienced hunger and I am satisfied with small amounts of food.  I tolerate everything I have tried with the exception of sugar.  I found out I dumped when I had some accidentally.  That is fine with me as I have extra incentive to stay away from it.  I can also tolerate milk again.
I have had no issues and I have lost all the weight I have regained.
I realize I am still very new so I don't know what the future holds.  I loved my first surgery at one year out, too.  I had such fears about having a RNY pouch because I have heard such horror stories about the "ruined for life" as they call it.  For me it isn't so bad.  Most days I forget I had surgery.  I haven't thrown up since I was 2 months out..
For me the real test will be if I keep the weight off.  I finally realize that I have a tool to help me eat right.  It won't make the food choices for me.  I have to do that but without the incessant hunger it is easier.
I still think the DS is a great surgery.  In hindsight, if I knew then what I know now I would have picked an experienced surgeon and I would have gotten a smaller stomach and a longer common channel.  My intestinal issues are much better.  I was having issues with constipation but it has been under control for a few weeks.
I hope that anyone who does have the DS has better education then I had and a good follow up program as well as a lot of support.  I had little support and when I started regaining I stopped going to my support group or participating in online forums.  Maybe if I had more support I could have done things differently but I can't change the past so I just do the best I can with what I have.
Hopefully I have learned from my experience and will make better choices this time.
I know I said I was going to keep this short but I guess I didn't do that, did I?

I chose RNY instead of DS for two primary reasons:
1) I was VERY concerned about the higher risk of vitamin deficiencies because of the extra bypass length with the DS.  The number of vitamin supplements needed with the RNY is about all I can handle and I was not sure I could commit to taking nearly twice the number of supplements long-term.  (My surgeon STOPPED DOING the DS about 2 years after I had my RNY because too many of her patients were finding it to be too much and were not taking their vitamins... and were experiencing a lot of serious health problems.  She said she coudl not, in good conscience, continue to do the DS knowing how many patients would end up becoming ill (even though THEY are the ones at fault for their failure to be compliant with vitamins.))
2) I was concerned about what would happen to my body when I got older (60s/70s/80s) when the body naturally becomes much less efficient at utilizing food.  Since the amount of intestine bypassed is so much greater with the DS, this becomes a much greater concern with the DS than with the RNY, and since I had this surgery MOSTLY to be healthier (and only secondarily to LOOK better), I did not want to endanger my future health any more than necessary to get the weight off.

Yes, the DS has better statistics regarding maintaining the weight loss, but THAT part of it I have more control over than the vitamin and malasorption issues.  I can be responsible for choosing what I put in my mouth and keeping the weight off!

Lora